If you’re at risk for tearing, your doctor may recommend making a cut to open up the area before you start pushing. This can allow for an easier delivery, but it could lead to some complications.
This article will explain what the perineum is and its role during childbirth, including how it may tear or be surgically cut. It also covers how to treat a torn perineum.
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What Is the Perineum?
Just behind the vagina is thepubis symphysis(the joint between the two pubic bones). Resting on this joint is the perineum. The area has less hair than the rest of the genitals.
At the center of the perineum is the perineal body, which is made up of tissue and muscle that strengthen the pelvic floor. The pelvic floor supports organs such as theintestinesandbladder. It plays a key role in bathroom function to help control urine and bowel movements.
The perineum is like a bridge supporting the muscles and functions of the reproductive, urinary, and digestive systems. If the tissue, nerves, or muscles that make up this bridge are damaged, it can cause problems with these systems.
Perineum Tears During Childbirth
Perineum tears are very common during childbirth. In fact, more than half of all women who give birth vaginally (as opposed to those who have aC-section), have some sort of perineal laceration.
There are four degrees of perineum tears, ranging from least severe to most severe.
How to Be Prepared for Labor and Giving Birth
What Is an Episiotomy?
Today, the World Health Organization (WHO) and the American College of Obstetricians and Gynecologists (ACOG) recommend that episiotomies be used only in limited cases. This is because research has shown that an episiotomy may make you more likely to develop a severe third- or fourth-degree tear.If your perineum tears naturally duringlabor and delivery, you may heal better than if a doctor forces a cut.
Your doctor should discuss the procedure and the risks in detail with you before your labor progresses too far. According to the WHO, mothers should give full consent to an episiotomy before it’s performed.
If an episiotomy is necessary, your doctor will numb the perineum to reduce pain. If you’ve already had an epidural or other anesthetics, though, you may not need any more medication.
Recap
It used to be common for doctors or midwives to make a cut in the perineum (episiotomy) to make delivery easier. But that’s now discouraged in most cases, as it can lead to more severe tears.
Healing After Childbirth
After an episiotomy or perineum laceration, your doctor may recommend the following to ease soreness and speed healing:
Over-the-counter pain relieversmay also help, but be sure to check with your doctor about which ones you can take, especially if you’re nursing or taking any other medication. You can also discuss the use of medicated creams or numbing sprays.
Do not use tampons or have sex until your OBGYN clears you to do so. Be sure to keep your postpartum checkup to ensure your perineum is healing correctly.
Perineum tears usually heal within two weeks.If you received stitches, they should dissolve within six weeks.
Using a Sitz Bath to Heal an Episiotomy
Complications
There is a risk of infection with a perineum tear. Signs of an infection may include an unusual odor or discharge from the wound, fever, or pain that can’t be managed with medication. If you have any of these symptoms, call your doctor.
With more severe tears, there are risks of long-term problems such as:
Preventing Perineal Tears
During pregnancy, you can work on stretching the perineum and preventing tearing through regular perineum massages. Also known as birth canal widening, perineum stretching can be done at home during the final weeks leading up to your due date.
The goal is to learn to relax your pelvic floor muscles and stretch the vaginal opening. Your obstetrician or midwife can show you how to give a perineal massage.
How to Massage the Perineum
Summary
The perineum is an often-overlooked area of your body, but it supports your internal organs. It also houses nerves and muscles that are important to a range of body functions.
In some cases, your doctor may think it’s best to make a small cut in the tissue to prevent you from tearing too much. Whether you have a cut from a doctor or one that occurs naturally while you push, you need to take care of a perineum laceration after childbirth to ensure that it heals well and that there are no long-term problems from damaged nerves or muscles.
Frequently Asked QuestionsMost doctors today recommend you avoid an episiotomy because it seems to increase the risk of severe lacerations of the perineum.But every situation is different. You should discuss both possible scenarios with your doctor before you are in active labor.The female perineum is found between the anus and the vagina. In males, it’s located between the anus and the scrotum.Learn MoreWhat You Should Know About the VaginaThe perineum is the area between the genitals and the anus.It supports the pelvic floor, the bottom of the pelvic cavity that holds your intestines, bladder, and other internal organs. Muscles and nerves that run through this small area control sexual function and the urinary and excretory systems.Learn MoreThe Role of the Perineum’s Pudendal Nerve
Frequently Asked Questions
Most doctors today recommend you avoid an episiotomy because it seems to increase the risk of severe lacerations of the perineum.But every situation is different. You should discuss both possible scenarios with your doctor before you are in active labor.
The female perineum is found between the anus and the vagina. In males, it’s located between the anus and the scrotum.Learn MoreWhat You Should Know About the Vagina
The female perineum is found between the anus and the vagina. In males, it’s located between the anus and the scrotum.
Learn MoreWhat You Should Know About the Vagina
The perineum is the area between the genitals and the anus.It supports the pelvic floor, the bottom of the pelvic cavity that holds your intestines, bladder, and other internal organs. Muscles and nerves that run through this small area control sexual function and the urinary and excretory systems.Learn MoreThe Role of the Perineum’s Pudendal Nerve
The perineum is the area between the genitals and the anus.It supports the pelvic floor, the bottom of the pelvic cavity that holds your intestines, bladder, and other internal organs. Muscles and nerves that run through this small area control sexual function and the urinary and excretory systems.
Learn MoreThe Role of the Perineum’s Pudendal Nerve
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hinata N, Hieda K, Sasaki H, et al.Nerves and fasciae in and around the paracolpium or paravaginal tissue: an immunohistochemical study using elderly donated cadavers.Anat Cell Biol. 2014;47(1):44. doi:10.5115/acb.2014.47.1.44Cleveland Clinic.Vaginal tears during childbirth.Ugwu EO, Iferikigwe ES, Obi SN, Eleje GU, Ozumba BC.Effectiveness of antenatal perineal massage in reducing perineal trauma and post-partum morbidities: A randomized controlled trial: APM for preventing perineal trauma.J Obstet Gynaecol Res. 2018;44(7):1252-1258. doi:10.1111/jog.13640Jiang H, Qian X, Carroli G, Garner P.Selective versus routine use of episiotomy for vaginal birth.Cochrane Database Syst Rev. 2017;2:CD000081. doi:10.1002/14651858.CD000081.pub3World Health Organization.WHO recommendation on episiotomy policy.Xiong K, Boehrer RH.Improving physician behavior with an obstetric dashboard.Obstetrics & Gynecology. 2017;129(1):140S-140S. doi:10.1097/01.AOG.0000514701.26361.13Siccardi MA, Bordoni B.Anatomy, abdomen and pelvis, perineal body.StatPearls Publishing.Additional ReadingJohns Hopkins Medicine Health Library.Episiotomy.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hinata N, Hieda K, Sasaki H, et al.Nerves and fasciae in and around the paracolpium or paravaginal tissue: an immunohistochemical study using elderly donated cadavers.Anat Cell Biol. 2014;47(1):44. doi:10.5115/acb.2014.47.1.44Cleveland Clinic.Vaginal tears during childbirth.Ugwu EO, Iferikigwe ES, Obi SN, Eleje GU, Ozumba BC.Effectiveness of antenatal perineal massage in reducing perineal trauma and post-partum morbidities: A randomized controlled trial: APM for preventing perineal trauma.J Obstet Gynaecol Res. 2018;44(7):1252-1258. doi:10.1111/jog.13640Jiang H, Qian X, Carroli G, Garner P.Selective versus routine use of episiotomy for vaginal birth.Cochrane Database Syst Rev. 2017;2:CD000081. doi:10.1002/14651858.CD000081.pub3World Health Organization.WHO recommendation on episiotomy policy.Xiong K, Boehrer RH.Improving physician behavior with an obstetric dashboard.Obstetrics & Gynecology. 2017;129(1):140S-140S. doi:10.1097/01.AOG.0000514701.26361.13Siccardi MA, Bordoni B.Anatomy, abdomen and pelvis, perineal body.StatPearls Publishing.Additional ReadingJohns Hopkins Medicine Health Library.Episiotomy.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Hinata N, Hieda K, Sasaki H, et al.Nerves and fasciae in and around the paracolpium or paravaginal tissue: an immunohistochemical study using elderly donated cadavers.Anat Cell Biol. 2014;47(1):44. doi:10.5115/acb.2014.47.1.44Cleveland Clinic.Vaginal tears during childbirth.Ugwu EO, Iferikigwe ES, Obi SN, Eleje GU, Ozumba BC.Effectiveness of antenatal perineal massage in reducing perineal trauma and post-partum morbidities: A randomized controlled trial: APM for preventing perineal trauma.J Obstet Gynaecol Res. 2018;44(7):1252-1258. doi:10.1111/jog.13640Jiang H, Qian X, Carroli G, Garner P.Selective versus routine use of episiotomy for vaginal birth.Cochrane Database Syst Rev. 2017;2:CD000081. doi:10.1002/14651858.CD000081.pub3World Health Organization.WHO recommendation on episiotomy policy.Xiong K, Boehrer RH.Improving physician behavior with an obstetric dashboard.Obstetrics & Gynecology. 2017;129(1):140S-140S. doi:10.1097/01.AOG.0000514701.26361.13Siccardi MA, Bordoni B.Anatomy, abdomen and pelvis, perineal body.StatPearls Publishing.
Hinata N, Hieda K, Sasaki H, et al.Nerves and fasciae in and around the paracolpium or paravaginal tissue: an immunohistochemical study using elderly donated cadavers.Anat Cell Biol. 2014;47(1):44. doi:10.5115/acb.2014.47.1.44
Cleveland Clinic.Vaginal tears during childbirth.
Ugwu EO, Iferikigwe ES, Obi SN, Eleje GU, Ozumba BC.Effectiveness of antenatal perineal massage in reducing perineal trauma and post-partum morbidities: A randomized controlled trial: APM for preventing perineal trauma.J Obstet Gynaecol Res. 2018;44(7):1252-1258. doi:10.1111/jog.13640
Jiang H, Qian X, Carroli G, Garner P.Selective versus routine use of episiotomy for vaginal birth.Cochrane Database Syst Rev. 2017;2:CD000081. doi:10.1002/14651858.CD000081.pub3
World Health Organization.WHO recommendation on episiotomy policy.
Xiong K, Boehrer RH.Improving physician behavior with an obstetric dashboard.Obstetrics & Gynecology. 2017;129(1):140S-140S. doi:10.1097/01.AOG.0000514701.26361.13
Siccardi MA, Bordoni B.Anatomy, abdomen and pelvis, perineal body.StatPearls Publishing.
Johns Hopkins Medicine Health Library.Episiotomy.
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