Perineal tears during birth: what to expect

Small tears may need little treatment, while deeper tears require careful stitching and follow-up. Your maternity team examines the vagina and perineum after delivery, explains what they found and provides pain relief and wound-care advice.

The perineum is the area between the vaginal opening and anus. A tear can involve skin, perineal muscle or, in a deeper injury, the muscles controlling the anus. The degree describes which tissues are affected; it does not measure your pain or predict exactly how quickly you will recover.

Soreness, bruising, swelling and stinging when passing urine can occur early in healing. Deeper injuries may also affect bowel control or pelvic-floor function, so planned follow-up matters even when the wound looks settled.

Use pain medicine as directed, keep the area clean with water, change maternity pads regularly and wash your hands before and after pad changes. Drink enough fluid and follow advice on preventing constipation; avoiding hard stools can make bowel movements more comfortable after a repair.

Begin gentle movement without pushing through worsening pain. Pelvic-floor exercises are often introduced gradually, and postnatal physiotherapy can help with weakness, discomfort, bladder leakage or returning safely to activity. Ask when intercourse, driving and strenuous exercise are appropriate for your recovery.

Contact your maternity team promptly if pain is increasing rather than easing, the wound opens, discharge smells unpleasant, swelling is worsening, or you develop fever or feel unwell. Heavy vaginal bleeding, faintness or severe weakness needs urgent assessment.

Report difficulty controlling wind or stool, sudden urgency, leakage from the bowel, or trouble passing urine. These symptoms deserve direct assessment because the repair, pelvic-floor muscles and bladder or bowel function may need review.

Ask which tissues were injured, what type of stitches were used, how to care for the wound, and when it will be checked. You can also ask what bowel symptoms should trigger a call, when to start pelvic-floor exercises, and whether specialist physiotherapy or a perineal clinic is appropriate.