Perineal tears

TL;DR

Perineal tears are a common occurrence during childbirth, affecting up to 90% of women delivering vaginally. These tears can range from minor to severe, potentially damaging the anal sphincter muscle and leading to complications such as chronic pain, sexual difficulties, and incontinence. Factors like baby size, induced labor, and assisted birth can increase the risk. Recent UK studies show a rise in severe perineal tears, highlighting the importance of awareness and proper care post-delivery.

If you are giving birth to a baby the old fashioned way, there is a 90 per cent chance that you will tear your perineum. This is the most common and minor form of tearing, but more severe tears can leave your anal sphincter muscle damaged. This is the muscle that controls your anus.

Tears, especially severe tearing, can really put a damper on your life, and cause fear for future pregnancies. Taking care of a new baby when you have a bleeding, weeping wound between your legs is also unpleasant and can be difficult. Long-term issues may include sexual difficulties, chronic pain, and incontinence.

It’s hard to tell who will tear and who won’t, but risk factors include a large baby, an induced labour, and assisted birth. Tears can also result from shoulder dystocia or a longer second stage of labour. UK statistics have reported an alarming increase in perineal tearing in first-time mothers, from 1.8 per cent in 2000 to 5.9 per cent in 2011. Another recent paper found that amongst those who had a vaginal delivery for their second birth, the severe tear rate was 7.2 per cent in women with a previous tear, compared to 1.3 per cent in women without a previous tear – five times as often.

Some theories behind the increase in tears include older age of first-time mothers, and women who are overweight, producing higher birth-weight babies. Better reporting and detection methods are also in place, with a standardised classification system now in place and improvements in training.

Minor cuts and tears can be encouraged to heal well with a vulva and vagina-friendly cuts cream.




Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
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