Perineal Tears

A perineal tear is a common type of birth injury. Discover everything you need to know. Contact Sydney Pelvic Clinic today for treatment.

There are a number of different types of tears that can happen during childbirth. A tear to the perineum is the most common type of these.

What are Perineal Tears?

Your perineum is the stretch of tissue located between your back passage (anus) and your vaginal opening. During vaginal childbirth, it is common for this area to tear.

There are different grades of tears:

• First-Degree Tears – These are small tears that only impact the skin. They tend to quickly heal without any treatment.
• Second-Degree Tears – These are tears that impact the muscle of the skin and perineum. Stitches are usually needed.
• Third and Fourth-Degree Tears – For some mothers (around 3.5 out of 100), the tear can be deeper. These tears, which are also known as obstetric anal sphincter injuries (OASI), extend into the muscle that controls the anus. These tears tend to need surgical repair at the time.

What are the symptoms?

You will typically experience pain while you are walking, sitting, or emptying your bladder or bowels, and this will last for around a week. The pain should slowly decrease.

However, you do need to be mindful of any signs of an infection, which include swollen, red skin around the tear, smelly discharge, and the area getting more and more painful, rather than the pain reducing.

How common are Perineal Tears with childbirth?

Perineal tears are common. In fact, as many as nine in every 10 first time mothers who have a vaginal birth experience some sort of graze or tear. They can also experience an episiotomy, which is a deliberate cut to assist with childbirth. This is a little bit less common for mothers who have had a vaginal birth before.

What are the risk factors associated with perineal tears?

You are more likely to experience a tear if you are having a vaginal birth for the first time. Other risk factors include an induction of labour, instrumental deliveries (forceps or vacuum-assisted), episiotomy, large babies, prolonged labour, and nulliparity (1st Birth).

What’s involved in a diagnosis?

At Sydney Pelvic Clinic, we can help to diagnose a perineal tear. Clients come in for a post-natal assessment six weeks after birth. Here, we will discuss your birth journey and what you are experiencing, how you are healing, and any concerns you have. If you have a perineal tear, we will be able to diagnose it at this stage and get you started on a treatment program to optimise your long-term outcomes.

What treatment is available?

As physiotherapists, we can help you to treat any sort of birth tear that you are experiencing. We will teach you perineal massage and recommend a tailored pelvic floor exercise plan. A perineal massage involves massaging the area between your anus and vagina to increase blood flow and help the tissue skin stretch with greater ease.

The massage can actually begin during pregnancy from 34 weeks onwards to prepare the perineum for birth and to reduce the likelihood of experiencing a tear. At this point we also teach you the correct pushing technique.

Are there any home-based treatments?

Yes, you can encourage a quicker recovery by taking the right course of action at home, i.e. regular massages and exercises. We can provide with edcuation on how to manage any pain associated with your tear, tricks to empty your bowels and how to look after your wound to optimise recovery.