Many women tear to some extent during childbirth. Most tears occur in the perineum, the area between the vaginal opening and the anus (back passage). They may be:
- First-degree tears – small, skin-deep tears which usually heal naturally
- Second-degree tears – deeper tears affecting the muscle of the perineum as well as the skin; these usually require stitches
For some women with a tear, the tear may be more extensive. This may be:
- A third-degree tear extending downwards from the vaginal wall and perineum to the anal sphincter, the muscle that controls the anus
- A fourth-degree tear extending to the anus or rectum
This leaflet provides information and advice about third- and fourth-degree tears during childbirth. It covers:
- Whether third- and fourth-degree tears can be prevented
- What to expect after a third-or fourth-degree tear
- What you can do to help you recover
- Implications for future births
This information is based on the RCOG Green-top Guideline No. 29 The Management of Third- and Fourth-degree Perineal Tears.
In line with the College process of reviewing all guidance every 3 years, this information is currently under review. The information in this version is still valid.