In plain words
A perineal laceration is a tear in the tissue between the vagina and anus that can happen when a baby is born. Some tears are small and heal on their own. Deeper tears reach into the muscle or the , and these need careful repair and follow-up. Your provider describes a tear by its degree, from first to fourth. Many people have some tearing or a cut, called an , and the choice depends on the birth. Tears can be sore for weeks. Tell your provider if you have heavy bleeding, increasing pain, fever, or trouble holding in gas or stool, since these need prompt attention.
The deeper version
Perineal laceration is classified by depth: first degree involves only the skin or vaginal lining, second degree involves the perineal muscles and without the anal sphincter, third degree involves the external anal sphincter, and fourth degree involves the anal mucosa. ACOG Practice Bulletin No. 198 (2018) addresses prevention and repair, including the role of restrictive episiotomy and of assessment for sphincter injury. RCOG Green-top Guideline No. 29 (2015) recommends systematic post-repair assessment for anal sphincter injury, since occult third- and fourth-degree tears are missed in a meaningful minority of cases. Risk factors include first vaginal birth, operative delivery, fetal size, and position, and long-term complications such as fecal incontinence are reported in a subset of those with sphincter injury.
Where it comes up
- Healing a tear or stitchesPostpartum: Your Body
- Perineal massage, tearing, and episiotomyGetting Ready for Birth
- Eating for tissue healingNourishment and Traditions
- Peeing after birth and leakingPostpartum: Your Body
- Your pelvic floor after birthPostpartum: Your Body
What mothers here say about perineal laceration
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Sources
- American College of Obstetricians and Gynecologists — Practice Bulletin No. 198: Prevention and Management of Obstetric Lacerations at Vaginal Delivery (2018)
- Royal College of Obstetricians and Gynaecologists — Green-top Guideline No. 29: The Management of Third- and Fourth-Degree Perineal Tears (2015)