To understand what perineal tears are, we first need to understand some of the anatomy. The perineum is the area of skin between your vagina and anus. A perineal tear is a common birth injury within that space, and there are different degrees/types of tears; and the type of degree will have different recovery options and outcomes.
What are the different types?
- First-degree: Only involving the skin.
- Second-degree: Involving the skin and the muscles underneath are torn.
- Third-degree: The tear extends into the muscle surrounding the anus (the anal sphincter)
a) Tearing of less than 50% of external anal sphincter
b) Tearing of more than 50% of external anal sphincter
c) Tearing of both external and internal anal sphincter - Fourth-degree: The tear goes through the anal sphincter and into the lining of the rectum
Most perineal tears are either first or second-degree, but in the case of a third or fourth degree tear, more intensive care and guidance is required – which our physiotherapists can assist with.
What can I do during pregnancy to reduce my risk of tearing when I deliver?
- Perineal massage from 34 weeks
- Pelvic floor muscle training – to gain awareness and knowing how to engage and relax the pelvic floor
- Be educated on birth positions that can lengthen the perineum
- Be educated on proper pushing technique during vaginal delivery
- Be educated on options that may be offered to you during delivery e.g. episiotomy
I have a small tear, do I still need to see a pelvic floor physiotherapist?
We recommend all new mums to do a post partum check from six weeks – yes, even if you have a small or no tear. The reason is because not only will our physiotherapists check the function, strength and co-ordination of your pelvic floor, they will assess you holistically. So, alongside pelvic floor muscle training, our physiotherapists will check how the rest of your body is recovering – this includes your core, hips/glutes strength and posture (just to name a few).
For more information, please do not hesitate to contact us on (02) 8883 5360 or email at info@sydneywomensphysiotherapy.com.au
Jasmine