Childbirth Injuries - perineal tearing
Childbirth injuries (including 3rd or 4th degree tears) can result in pain and muscle weakness which takes time to recover from.
While some women recovery quickly from their delivery, others find that they have quite significant discomfort and changes in function.
If you have had a third or fourth degree tear repair, you are at an increased risk of symptoms such to bowel incontinence.
With good physiotherapy management the chance of these problems occurring can be significantly reduced.
What causes childbirth injuries?
There are a number of known factors which increase the chance of deep perineal tearing or pelvic floor damage during delivery. These include:
Instrumental Delivery (forceps or ventouse/vacuum)
Large Baby (especially birthweight >4kg)
Prolonged second stage of labour (especially more than 2 hours active ‘pushing’)
Large infant head circumference,
Shoulder dystocia of the baby (shoulder stuck behind mother’s pubic bone)
Having a previous severe perineal tear (you have an increased chance of tearing again)
Occipito-posterior position of the baby (back of baby’s head against mother’s spine)
What are the signs and symptoms?
If you experienced a third or fourth degree tear you may experience:
Excessive pain when attempting to sit
Excessive swelling/ bruising in the perineal area
Pain/ Apprehension when passing urine or bowel motions
Pain when returning to sex
Decreased sensation to empty the bladder
Urinary (bladder) or faecal (bowel) incontinence
Urinary or faecal urgency
What can be done to help me?
A comprehensive assessment of your pelvic floor muscles and symptoms can be performed to determine the most appropriate forms of treatment.
Treatment options include:
Pelvic Floor muscles strengthening
Pelvic Floor muscle relaxation
Perineal/ scar massage/ desensitization
Education about good bladder and bowel habits
Education about appropriate and safe return to exercise
It is not uncommon for women who have experienced a sever childbirth injury to suffer from the effects of birth trauma. If this is you, we encourage you to speak up and seek support from your healthcare team and we can also recommend the Australasian Birth Trauma Association as a great support network to connect with.