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Perineal Tear with Delivery

Medically reviewed by Last updated on Jan 5, 2023.

What is a perineal tear?

A perineal tear can occur during vaginal delivery. The perineum is the area that includes your vagina and anus. There are 4 different types of perineal tears that may occur during delivery.

  • A first degree tear is a tear of 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.

What increases my risk for a perineal tear?

There is no way to know if you will have a perineal tear during delivery. Your risk may be increased if it is your first vaginal birth or you deliver a large baby. Your risk is also greater if your baby is in a position other than the usual head-down position during delivery. Your risk may also be increased if you have had a perineal tear during a previous vaginal delivery.

How is a perineal tear treated and managed?

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 need pain medicine to decrease pain. You may need to take laxatives or stool softeners to make it easier for you to have a bowel movement. This can help decrease pain during bowel movements.

How is a perineal tear managed at home?

  • Apply ice on your perineum for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
  • Keep your perineum clean and dry. Wash your perineum gently with soap and water. Rinse your perineum and pat dry with a soft, clean towel.
  • Change your sanitary pad regularly. Wash your hands well before and after you change your sanitary pad.
  • Ask about pelvic floor exercises. Your healthcare provider may recommend that you do these exercises within 7 days of delivery.

When should I contact my healthcare provider?

  • You have a fever of 100.4°F (38°C) or higher.
  • You have increased pain.
  • You have increased discharge that has changed color or smells bad.
  • You have increased swelling.
  • You have questions or concerns about your condition or care.

Care Agreement

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. 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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Further information

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