Up to one in three new mothers in Australia have some degree of birth trauma. As the understanding of birth trauma grows, the need to seek professional postnatal support becomes increasingly clear.

The most common childbirth injuries are perineal tears,  levator avulsions (injury to the pelvic floor muscles), Pubic Diastasis, coccyx fractures. With education, pelvic floor muscle training, and simple treatments like perineal massage, it is possible to reduce the likelihood, severity and impact of any birth trauma. Speak to our pelvic health physiotherapists at Sydney Pelvic Clinic to regain control of your recovery today.


What Are Perineal Tears?

Perineal tears are a form of injury to the perineum, which is the region of skin, connective tissue, and muscles between the vagina and the anus. Tears can occur during childbirth and come in four degrees of severity. The first and second degrees are the most common and do not extend to the anus. Third and fourth-degree tears, scientifically known as obstetric anal sphincter injuries, can damage the external sphincter and tear the inner lining. Third and fourth-degree tears may also lead to changes in control and sensation around the back passage.

How Common Are Perineum Tears?

It is shown that up to 90.4% of women having their first child will have some degree of perineal tear, making them the most common type of birth trauma. While the majority of women who experience this will fall into categories 1 and 2, about 3% of women sustain types 3 and 4. 

Women may have also had an Episiotomy, which is a deliberate cut made by the surgeon during childbirth to prevent a 3rd or 4th degree injury.

How Are Perineal Tears Diagnosed?

Women who have sustained a perineal tear may experience pain during bowel movements or physical movements for a week or so. However, worsening pains and swelling in the area must not be ignored. Our physiotherapists at Sydney Pelvic Clinic can check into the healing of a perineal tear at a postnatal assessment 

How Are Perineum Tears Treated?

Women who experience tears during childbirth will require stitches. Once healing has occurred, it is important to then perform scar massage/desensitisation to prevent long-term sensitivity and pain in the area.

Our physiotherapists here at Sydney Pelvic Clinic can also help to prevent the severity of tears, prenatally,  by teaching perineal massage from week 34 onwards in your pregnancy to aid recovery and subsequently prevent persistent sensitivity in this region.

Following a detailed assessment, you will require an individualised program to manage the injury. This could include a combination of advice on bowel habits with pelvic floor retraining exercises, scar massage, and de-sensitisation techniques. 

Learn more about Perineum Tears

What Is Pubic Diastasis?

Pubic diastasis is a rare but debilitating condition that occurs during pregnancy or delivery. It involves the pubic symphysis – the joint at the front of the pelvis – widening by more than 1cm.

The condition is typically associated with prolonged active labour, twin and triplet pregnancies, large babies, and biomechanical changes to the pelvis during pregnancy.

How Is Pubic Diastasis Diagnosed?

Pubic Diastasis occurs in fewer than 1 in 300 (and maybe as few as 1 in 3,000) vaginal births. It is most commonly diagnosed at a postnatal assessment, once post-birth pain and swelling has resolved. There may be ongoing pain and discomfort when walking, climbing stairs, getting out of the car, or other single leg activities.

Your postnatal check is also an opportunity to discuss your birthing journey, any birth trauma, and other related issues.

How Is Pubic Diastasis Treated?

Sydney Pelvic Clinic can help provide external support to the pelvis via belts and abdominal binders while offering guided exercise to help you regain joint stability.

Conservative management of the condition yields very good outcomes, with most women achieving full recovery without surgery.

Learn more about Pubic Diastasis

Levator Avulsion

Levator avulsion is when some degree of the levator ani muscles – a broad sheet of muscle in the pelvic floor region – is pulled away from its attachment behind the pubic bone. The injury is commonly categorised as either a “complete avulsion” where the muscle is not connected to the pubic bone on one side, or a “partial avulsion” where some connection is still present. It is also possible for a levator avulsion to occur on one side or both sides.

A levator avulsion does increase your risk of developing prolapse, which is when one or more of the pelvic organs descend down towards the vagina. This is often felt as a sensation of heaviness or dragging around the vagina, or the sense of a bulge at the entrance. 

Get The Support You Deserve With Birth-Related Injuries

Childbirth injuries are common but there are many ways new mothers can manage them and recover well. If you’re  preparing for childbirth or seeking the right treatment following a difficult birth experience, Sydney Pelvic Clinic is here to help.

Our friendly physiotherapists are 100% dedicated to delivering a personalised plan to help you enjoy motherhood to the max. Book a Postnatal Assessment today.