Perineal tears

If your baby’s head is large or he delivers very quickly it’s possible you might tear.

There are four degrees of perineal tears:

First degree is when there are minor tears to the area around the entrance to the vagina – these usually heal well and most don’t need stitches.

Second degree is when the tear goes through the skin and the perineal muscles underneath, leaving the anal sphincter muscles intact. These tears will need several stitches through the muscle and tissue in the perineal area and may cause some discomfort.

Third degree is where the anal sphincter muscles are torn, but the lining inside the rectum remains intact – these tears require careful stitches to repair.

Fourth degree is where the anal sphincter is torn and the anal mucosa is opened and requires skillful stitching. This degree of tearing is very rare in a medically supervised birth, because your OB-GYN or nurse-midwife is likely to perform an episiotomy in order to avoid it.

Your OB-GYN or nurse-midwife will do their utmost to avoid carrying out an episiotomy because of the painful healing process afterwards. The good news is that any damage does usually heal – studies have shown that women who tear, women who don't and women who have episiotomies all have the same level of pelvic floor muscle strength three months after giving birth.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

Related Articles

• Guide To : Toddler: Month nineteen
• Mum Health: Stitches and swelling
• Guide To : Labour and Birth: HypnoBirthing - Trudy's story
• Education: Reading with your preschooler
• Mum Health: Your perineum