HealthInfo Canterbury
Perineal tear
Your perineum is the area between your vagina and anus (back passage or bottom). Many women tear their perineum during childbirth.
- First-degree tears are small tears of just the skin and don't usually need stitches.
- Second-degree tears are deeper and affect the muscle as well as the skin and need stitches to be repaired.
- Third-degree tears involve tearing of the vaginal wall and the anal sphincter (the muscle that controls the back passage).
- Fourth-degree tears extend to the lining of the back passage, or anus.
Causes of perineal tears
Often there is no clear reason for tearing. There is an increased risk for women who:
- have their first vaginal birth
- have a long pushing phase of their labour (over two hours)
- need a forceps or ventouse (suction) birth
- have a large baby
- have the baby's shoulder stuck behind their pubic bone (shoulder dystocia)
- had labour induced.
Preventing perineal tears
This information explains how to massage your perineum in the weeks leading up to your delivery to reduce the risk of it tearing.
On the next page: Self-care after a perineal tear
Written by HealthInfo clinical advisers. Last reviewed February 2022.
Review key: HIGIB-113323
