A perineal tear is a type of trauma resulting from vaginal birth, occurring at the perineum – the area between the vagina and anus.
Risk factors for perineal tearing include a baby >4000g, extended second stage of labour, commonly known as the ‘pushing stage’ and the use of forceps or vacuum.
Most women will sustain some form of perineal tearing during vaginal birth. Tearing is graded from 1-4 with Grade 1 resulting in tearing and grazing to the skin, and Grade 4 involving trauma to the internal and external anal sphincter.
For most women, the general symptoms following a tear are swelling and discomfort due to the stitches. This can be managed with rest, ice pads made out of sanitary pads, compression using tight underwear and elevation using a pillow under the pelvis. Short pelvic floor muscle contractions and relaxations can also help as the muscle acts like a pump to move the swelling and promote blood flow for healing.
Grade 3 and 4 tears are also known as Obstetric Anal Sphincter Injuries or OASIs. They include involvement of the external +/- internal anal sphincter. The importance in differentiation of these tears is that involvement of the sphincters can result in bowel dysfunction such as faecal or flatal incontinence (the inability to control faeces or wind). This is particularly distressing for women and all women who sustain a Grade 3 or 4 tear are recommended to have a routine appointment with a Continence and Women’s Health Physio to support recovery.
Other symptoms women can report following a tear are urinary incontinence (leakage of urine), prolapse symptoms (the feeling of a heaviness, dragging, lump or bulge around the vagina) or pain with intercourse.
Perineal tears can be prevented by completing pelvic floor muscle training and perineal massage in pregnancy.
There are also treatments available for symptomatic relief of perineal tearing such as laser therapy for scar healing and ultrasound therapy to promote reduction in swelling and pain.
All of these treatment options and advice and support regarding any of the above issues is available from Leonie at Embodied Confidence. Appointments can be booked online or call 91431510 for more information.