Many (9 out of 10) women tear to some extent during childbirth. But this rarely causes a problem in the future. 

Most tears occur in the perineum, (the area between the vaginal opening and the anus (back passage))

First and Second Degree Tears

First Degree Tear

Small, skin-deep tears which usually heal

The stitches that are used will dissolve.

Second Degree Tear

Deeper tears affecting the muscle of the perineum as well as the skin; these usually require stitches

The stitches that are used will dissolve.

After care if you have had a vaginal tear

Before you are discharged, the midwife or doctor will advise you specifically on how to care for any vaginal tear.

General advice:

  • Keep the area clean and dry 
  • Avoid constipation
  • Pelvic floor exercises
  • Report any concerns you may have to your midwife, health visitor or GP

If you have had a third or fourth degree tear; please see section about and links to patient information for specific advise for after care.

Third and Fourth Degree Tears

For some women with a tear, the tear may be more extensive. This may be:

Third Degree Tear

A third-degree tear extending downwards from the vaginal wall and perineum to the anal sphincter, the muscle that controls the anus

Fourth Degree Tear

A fourth-degree tear extending to the anus or rectum

It is very difficult to predict when these tears will happen and therefore prevent. It is important however, for them to be identified and treated appropriately.

After your delivery the midwife will examine to see you have had a tear. If they feel it could be a 3rd or 4th degree tear they will ask the doctor (obstetrician) to review.

It is likely that the doctor will recommend he/she repair the tear in an operating theatre.

This to provide good light and good pain relief to reduce any complications from the tear for the future.

The stitches used will dissolve.

What if I have had a previous third or fourth degree tear?

If you sustained a third or fourth degree tear in a previous pregnancy and you are now pregnant please let your midwife know.

You will receive information, advice and talk through the best delivery for you and your baby.

If you have had a fourth degree tear you will be offered an appointment with a consultant obstetrician, if you wish to talk through you options.


It is common that an episiotomy (a cut to the perineum) will be required with an assisted birth.

This is to prevent a more significant tear.

Any tear or cut will be repaired with stitches that will dissolve.

Perineal tears during childbirth

Perineal tears during childbirth


Pelvic, Obstetric & Gynaecology Physiotherapy

Pelvic, Obstetric & Gynaecology Physiotherapy


Pelvic Floor Muscle Exercises

Pelvic Floor Muscle Exercises