Perineal tearing is common during childbirth. Here’s what you need to know.

The perineum is the space between the opening to the vagina and the anus. There are 4 grades of perineal tears:

• Grade 1- tear or laceration involving the first layer of skin around the vagina and perineal area
• Grade 2- (most common), tear extending through the skin into the muscle of the pelvic floor or vagina
• Grade 3- tear extending from the vagina to the anus, which involves skin, muscle, and external anal sphincter
• Grade 4- (least common) tear extending from the vagina to the anus, which involves the skin, muscle, external anal sphincter, and internal anal sphincter

Grade 2-4 tears will likely be repaired with stitches immediately following birth. Grade 1 tears might not require stitches and may be left to heal on their own.

To decrease sensitivity, discomfort, and tension around a perineal tear or scar, you can perform perineal desensitization techniques externally immediately postpartum and perineal scar massage techniques internally following physician clearance at the postpartum checkup.

Perineal massage starting at 35 weeks gestation may help reduce high-grade tears. This technique will help you feel and prepare for the sensation of your tissues stretching similar to how they will during the vaginal birth process.

For a personalized recovery plan, ask your doctor for a referral to Pelvic Health Physical Therapy at your first postpartum visit. Schedule an appointment with one of our Pelvic Health PTs who would be happy to assist you in your recovery.