Understanding the Different Degrees of Perineal Tears During Childbirth

For pregnant women, an important part of the childbirth process is understanding how to recognize and manage the different degrees of tears that may occur during delivery. It’s important to be informed about the types of tears that can occur so you can be prepared if any are experienced. Today we will discuss ?the different types of tears why it matters.

So firstly let's explain exactly what we are discussing when we talk about tears.

The perineum is the area of skin and tissue between a woman’s anus and her vagina. During childbirth, this area is put under a lot of strain as the baby’s head passes through the birth canal. As a result, it is common for women to experience some degree of tearing in this area. However, not all tears are equal. There are four degrees to consider when it comes to perineal tears during childbirth, it is important to remember that the more severe types I.e third and fourth degree are very rare occurring in around 6 in 100 births for first time mothers and 2 in 100 for women who have had a vaginal birth before.

Let’s take a look at each one in turn.

First-Degree Tear

A first-degree tear is the least severe type of tear and only affects the skin around the vaginal opening. These tears typically heal in around two weeks many do not require stitches as they will heal well by themselves. It's important to note that these types of tears may be slightly uncomfortable while they're healing, so women should make sure they get plenty of rest, eat healthily, and keep well hydrated.

Second-Degree Tear

Second-degree tears involve damage to both the skin around the vagina as well as part or all of the underlying muscle layer beneath it. These types of tears usually require stitches which will usually be done by the same midwife who delivered your baby and in the same room that you gave birth in. The stitches used will be dissolvable so there will be no need for them to be removed by a doctor or midwife. Second-degree tears generally take up to four weeks to heal completely but can vary from person to person depending on how complex the particular tear was.

Third-Degree Tear

Third-degree tears affect both skin and muscle layers and go deeper into underlying muscles of the internal and external anal sphincter, these are very thin muscles which control your bowel function. Your clinician will be able to classify this tear further into either a 3 a, b, or C depending on how much of the anal sphincter muscle has been torn.

This type of tear will be stitched by a specially trained doctor in the theatre, this allows you to have complete pain relief and the doctor has the optimal environment for repairing the trauma.

In the days after the procedure, you will be offered pain relief and will be checked over by your community midwife. In the weeks following the birth you may be offered an appointment at a specialist clinic.?????????????

Fourth Degree Tear

Fourth degree tears are the most severe form of perineal trauma but are very rare, they are when both the internal and external anal sphincter are torn. They will be stitched by a very well trained doctor and they may request the assistance of a colorectal surgeon.

You will be followed up in a specialist outpatients' clinic and may be offered an endoanal?scan which will give a ultrasound image of the muscles of the back passage and show how well they have healed.

Conclusion:

No matter what type of tearing you experience during childbirth, it's important that you get examined by your medical care provider afterwards so that any potential issues can be addressed promptly before they become more serious problems later down the road. Perineal tearing can cause some discomfort during the postpartum recovery but with proper medical treatment (and rest!), any degree tear has the potential to heal well and remember if you are suffering symptoms form a third or fourth degree tear there are health care professionals out there that want to help you.

If you are suffering from anything mentioned in this article then we would suggest speaking to the The MASIC Foundation who are a UK charity to support women who have suffered severe injuries during childbirth known as OASI (Obstetric Anal Sphincter Injuries).

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