Episiotomy and third-degree tear: what to know

An episiotomy is a deliberate cut in the perineum, the skin and muscle between the vagina and anus. A third-degree tear is an unplanned extension that reaches the anal sphincter. Clinicians may describe the injury in more detail depending on how much of that muscle is affected. This is different from a fourth-degree tear, which also involves the lining of the rectum.

Repair is generally performed after the birth with suitable pain relief and careful examination. Healing can affect sitting, walking, bowel movements and sexual comfort for a while. The extent of symptoms does not always show the full depth of the injury, so scheduled review matters.

Follow the repair team’s instructions about wound care, prescribed medicines and keeping stools soft. Rinse gently with clean water, pat dry, change pads regularly and avoid inserting anything into the vagina until your clinician says it is appropriate. A fibre-rich diet, fluids and any recommended stool-softening treatment can reduce straining.

Build activity gradually and use the resting position that feels most comfortable. Pelvic-floor rehabilitation can help restore control and confidence once your maternity team considers it suitable. Discuss pain, bowel control, wind leakage or discomfort with sex openly; these symptoms deserve assessment rather than silent endurance.

Contact your maternity unit or clinician promptly for worsening pain, increasing swelling, fever, feeling unwell, offensive-smelling discharge, wound separation or bleeding that becomes heavy. Seek urgent help for loss of bowel control, inability to pass urine, severe pain, or sudden dizziness with bleeding. These signs can indicate infection, a wound problem or another postpartum complication.

Ask which structures were involved, how the repair was checked, when review is planned, what bowel-care plan to follow, and when pelvic-floor exercises, driving, work and sex can be resumed safely.