Vaginal Delivery Perineal Tears

Oftentimes, when a woman has a vaginal delivery, a tear occurs in the area between your vagina and anus, or your perineum. Though it’s most common in women experiencing their first vaginal birth, it’s possible to tear during any vaginal delivery.

Types of Perineal Tears

Perineal tears vary in severity. These are the degrees of lacerations:

• First-degree (Superficial tear) – This occurs when the skin of the perineum and the tissue around the vagina tear. However, no muscles tear.

• Second-degree lacerations – Second-degree lacerations go deeper into the muscle and often require stitches to heal.

• Third-degree lacerations – These lacerations tear the vaginal tissue, perineal skin and perineal muscles that extend to the muscle that surrounds the anus.

• Fourth-degree lacerations – These severe lacerations go through the anal sphincter and the tissue underneath the sphincter. Third or fourth degree lacerations can lead to incontinence of stool or gas if improperly repaired.

People who are most at risk for third and fourth-degree lacerations include women who pushed for a long time, women who give birth to large children, women who have assisted delivery and women who have an episiotomy.

Treating Episiotomy or Perineal Tear

• If you have a first or second degree tear, it will be repaired immediately after the delivery of the placenta. Though not all first degree tears require stitching, repairing the perineal will help in early healing and maintaining the anatomy of the vagina.

• Third and fourth degree lacerations may require surgical repair under anesthesia, depending on the severity.

Dr. Thad Denehy and Dr. Robert Taylor repair extensive perineal lacerations that occur after childbirth. Call 973-243-9300 to schedule an appointment.