Third-Degree Tear Healing: What to Expect

A third-degree tear is a perineal tear from childbirth that extends into the anal sphincter muscle. It is repaired with stitches, usually soon after birth, and needs follow-up because the repair involves a muscle that helps control wind and bowel movements.

Soreness, swelling, bruising, pulling around the stitches, and discomfort when sitting or passing urine can occur early in recovery. Bowel movements may feel worrying, but straining can put extra pressure on healing tissue. Healing is gradual; the skin may feel better before deeper muscle tissue has fully recovered.

Take prescribed pain relief and any stool-softening medicine as directed. Drink fluids, choose fibre-containing foods if they suit you, and avoid pushing hard during a bowel movement. Keep the area clean and dry with gentle washing; pat rather than rub. Change maternity pads regularly and wash your hands before and after touching the area.

Rest when possible and increase walking gently rather than returning quickly to strenuous activity. Avoid lifting heavily, vaginal intercourse, and inserting anything into the vagina until your clinician confirms that healing allows it. Pelvic floor exercises can be useful, but begin or progress them with guidance, especially if they cause pain or pressure. A follow-up assessment can check the wound, muscle function, bowel control, and recovery plan.

Postnatal physiotherapy may help you learn graded pelvic floor exercises, breathing, posture, and ways to reduce strain during daily activities. Perineal repair follow-up can address wound concerns and ongoing symptoms.

Contact your maternity or surgical care team promptly if pain is worsening rather than easing, the wound opens, swelling becomes pronounced, or the area develops increasing redness, heat, discharge, or an unpleasant smell. Fever or feeling generally unwell can also signal infection and needs assessment.

Seek urgent advice if you cannot control gas or stool, notice stool passing through the vagina, or have heavy bleeding, severe pain, faintness, or difficulty passing urine. These symptoms do not confirm a complication, but they should not wait for a routine appointment.

Ask when your repair should be checked, which pain relief and bowel medicines are suitable for you, and when to start or advance pelvic floor exercises. You can also ask what activity, bathing, driving, sex, and lifting limits apply to your recovery.

If you have urgency, leakage, pain with intercourse, or fear around bowel movements, describe the symptom and how it affects you. Your clinician can decide whether you need examination, specialist review, or postnatal physiotherapy.