What are the treatment options for perineal tear?

A perineal tear can affect the skin, vaginal tissue or muscles between the vagina and anus after birth. A midwife or doctor examines the wound to assess its depth, bleeding and muscle involvement. Small tears may heal with hygiene, comfort measures and monitoring, while deeper tears generally need stitches in a suitable clinical setting.

Perineal Repair uses dissolvable stitches to bring the tissues together and restore muscle support. Local or regional anaesthetic may be used, and stronger pain relief or antibiotics may be offered when clinically indicated. Keeping the area clean, changing pads regularly and preventing constipation can support comfort while it heals.

Use prescribed or clinician-approved pain relief, rest when possible and try a cold pack wrapped in cloth for short periods. Drink fluids, eat fibre and follow advice about stool-softening medicine so bowel movements do not strain the repair. Avoid inserting anything into the vagina until your maternity clinician says healing is adequate.

Postnatal Physiotherapy can help with pelvic-floor rehabilitation, scar comfort, movement and return to activity. Tell your clinician about pain with sex, difficulty controlling wind or stool, a pulling sensation, or fear of movement; these concerns can be assessed and treated.

Contact your maternity team promptly for increasing pain, new swelling, wound separation, pus-like discharge, fever, offensive smell or bleeding that becomes heavy. Seek urgent help for severe pain, faintness, inability to pass urine, or new loss of bowel control. A sudden change after initial improvement also warrants review.

Ask how deep the tear is, whether repair is needed, how to care for the stitches, which pain relief is compatible with feeding, and when to begin pelvic-floor exercises. Ask what symptoms suggest infection or wound separation and when a postnatal physiotherapy referral is appropriate.