Perineal Tearing

Tearing of the perineum (the area between the genitalia and the anus) can occur during vaginal delivery and is categorized into four degrees. First and second degree tears are fairly common, while third and fourth are more rare (less than 1% of vaginal deliveries). One of the largest risk factors for a third or fourth degree tear is the use of forceps during delivery. The larger degree of tear, the higher the chance of developing pelvic floor muscle dysfunction including pain, urinary incontinence, and bowel incontinence.

Episiotomies, which are a surgical cut made through the perineum, are becoming less common in developed countries as outcomes are showing that natural tearing tends to heal better than a surgical cut and evidence does not show that it prevents a third or fourth degree tear from occurring. Over the past twenty years, advocacy efforts have led to a general consensus that episiotomy should no longer be conducted as a standard practice.

A pelvic health physical therapist can make sure your tissues are healing well and provide education on how to care for your scar at home. Since the perineum is of great importance for pelvic floor muscle function, performing specific exercises assigned by a pelvic physical therapist can help to prevent unwanted issues from arising postpartum.