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Perineal tears sustained during childbirth

What are perineal tears?

Your perineum is the area between your vaginal opening and back passage (anus).

It is common for the perineum to tear to some extent during childbirth.

Tears can also occur inside the vagina and in the labia.

Up to 9 in every 10 women will experience some sort of tear or graze.

For most women, these tears are minor and heal quickly.

Anatomy of the perineum


What are the types of perineal tear?

First degree

Small tears affecting only the skin which usually heal quickly and without treatment.

Read more about first degree tears

Second degree

Tears affecting the muscle of the perineum and the skin. These usually require stitches.

Read more about second degree tears

Third and fourth degree tears

For some women (3.5 out of 100) the tear may be deeper. Third or fourth degree tears, also known as obstetric anal sphincter injuries (OASI), extend into the muscle that controls the anus (anal sphincter). These deeper tears need repair in an operating theatre.

Read more about third and fourth degree tears

Types of tears that can occur


Why do tears occur?

Tears happen spontaneously as the baby stretches the vagina and the perineum during birth.


What is the difference between a tear and an episiotomy?

An episiotomy is a cut made by your healthcare professional into the perineum and vaginal wall to make more space for your baby to be born.

Episiotomies are done with your consent.

They are only done if your baby needs to be born quickly, often if you are having an assisted (instrumental) birth, or if you are at risk of a serious perineal tear.

Read more about episiotomies


How do I know what type of tear I have?

After the birth of your baby, your healthcare professional will carefully examine your vagina, perineum and rectum to see if you have a tear, and if so, what type. They will then advise you if you need stitches.

If you have sustained a third or fourth degree tear, you will be transferred to the operating theatre where your muscles will be repaired. You will be given an epidural or spinal anaesthesia, so that you have good pain relief and can be examined thoroughly.


Further information



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