What should you know about a first-degree perineal tear?

The perineum is the area between the vaginal opening and anus. A first-degree tear involves the skin and may cause soreness, stinging when urine touches the area, or light bleeding. It does not extend into the deeper perineal muscles. A clinician checks the tear after birth to decide whether its edges are likely to come together without stitches or whether repair would support healing.

Tenderness can be more noticeable when sitting, walking, passing urine, or having a bowel movement. The discomfort should gradually settle as the tissue heals. Healing can feel slower if the area is swollen, rubbed by clothing, or strained by constipation.

Keep the area clean with water, pat dry rather than rubbing, and change maternity pads regularly. A cool pack wrapped in cloth can ease swelling for short periods. Drink fluids and choose fibre-rich foods to help keep stools soft; avoid straining. Follow the pain-relief advice given by your maternity team, especially if you are breastfeeding.

Rest when you can and increase walking gently as comfort allows. Pelvic floor exercises may be introduced gradually after birth, with guidance if the area remains sore. Postnatal Physiotherapy can help if discomfort, scar sensitivity, or pelvic floor symptoms continue.

Contact your maternity team if pain is worsening rather than easing, the wound becomes increasingly red or swollen, discharge smells unpleasant, or you develop a fever. Seek urgent help for heavy bleeding, feeling faint, severe pain, or difficulty controlling urine or stool. Arrange a review if the wound appears to open or if intercourse remains painful after healing time and medical advice.

Ask whether the tear needs stitches, which pain medicines are suitable for you, and when pelvic floor exercises can begin. You can also ask how to recognise infection, whether your symptoms fit normal healing, and whether Perineal Repair or Postnatal Physiotherapy is appropriate.