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Perineal Tear with Delivery

Medically reviewed by Last updated on May 1, 2023.

A perineal tear is a tear that occurs on your perineum during vaginal delivery. The perineum is the area that includes your vagina and anus. A first degree tear is a tear on the perineal skin only. A second degree tear involves the perineal muscles. A third degree tear extends into the anal sphincter (the muscle that surrounds your anus). A fourth degree tear involves the anal sphincter and the tissue underneath it.


Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.


  • Pain medicine may be given. Ask how to take this medicine safely.
  • Laxatives or stool softeners may be given. These make it easier for you to have a bowel movement. This can help decrease pain during bowel movements.


Ice will be applied to your perineum to decreasing swelling and pain. First or second degree tears may require a few stitches. Third or fourth degree tears will require surgery to repair damage to the anal sphincter and tissues underneath.


You may develop an infection, or your stitches may come apart. You may continue to have pain for up to 8 weeks. You may have trouble controlling urine, gas, or bowel movements if you have a third or fourth degree tear. You may develop adhesions after surgery to repair a perineal tear. Adhesions are bands of scar tissue.


You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.