Ways to reduce perineal tearing during birth

The perineum lies between the vaginal opening and anus. During vaginal birth, its skin and muscles stretch around the baby and may tear. Some tears affect only skin, while deeper injuries involve perineal muscle or the muscles around the anus.

Tearing is not proof that you pushed incorrectly or failed to prepare. Tissue response, the baby's position, the speed of birth, assisted delivery and other features of labour can all influence what happens.

Ask your midwife whether antenatal perineal massage is suitable and how to perform it without causing pain or injury. During labour, positions such as side-lying, kneeling or being on hands and knees may allow you to respond to pressure and make space for a controlled birth.

Near crowning, the maternity professional may offer a warm compress and support the perineum. Follow guidance to slow or pause active pushing when asked, using short breaths while the head emerges. These measures can support gradual stretching but cannot guarantee an intact perineum.

After a tear or repair, seek prompt advice for worsening pain, spreading redness or swelling, fever, unpleasant-smelling discharge, pus, wound opening or new difficulty passing urine. Heavy bleeding, faintness, severe weakness or rapidly increasing swelling needs urgent assessment.

Report trouble controlling wind or stool, bowel urgency, persistent pelvic pressure, urine leakage or pain that interferes with sitting, walking or sex. These symptoms should be assessed rather than accepted as an inevitable part of recovery.

Ask which positions and perineal-support techniques your birth setting offers, how tears are examined after delivery and who performs a repair if needed. If you had a deeper tear before, discuss how it affects birth planning and whether postnatal physiotherapy should be arranged early.