What Is a Third-Degree Tear?

What are the degrees of perineal tear?

Perineal tears are graded by how deep they are. A first-degree tear affects only the skin. A second-degree tear also involves the muscle of the perineum. A third-degree tear extends into the anal sphincter, and a fourth-degree tear goes further, into the lining of the anus or rectum. Third- and fourth-degree tears are also called obstetric anal sphincter injuries (OASI).

Who is more likely to have a third-degree tear?

A third-degree tear is more common during a first vaginal birth. Other factors include a large baby, a long pushing stage, an assisted birth with forceps or ventouse, and a baby facing upwards. In many cases, a tear happens without any clear reason. An episiotomy may be offered in some assisted births.

How is a third-degree tear repaired?

A third-degree tear is usually repaired soon after birth, often in an operating room with a spinal or epidural anesthetic. Afterwards, the care team usually offers pain relief, antibiotics and medicines to make bowel movements softer, plus a follow-up appointment.

What is recovery like after a third-degree tear?

Most people recover well, but some have pain or problems controlling wind or bowels for a time. Pelvic floor exercises and physiotherapy can help. Anyone with ongoing symptoms should talk to their GP or midwife, and emotional support is available for those who find the birth distressing. On returning to work, toilet access and comfortable seating can help.

Sources: NHS, RCOG.