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Perineal tear in childbirth

Ruptura perinei · Poranění hráze při porodu

female only

What it is

Nine in ten first vaginal births tear the skin between vagina and anus; 3–6% tear into the anal sphincter, which must be repaired to prevent incontinence.

Symptoms & signs

  • Pain and swelling of the perineum
  • stinging on urination
  • pain on sitting
  • leaking wind or stool after a sphincter tear
  • pain during sex months later

🚩 Get help if…

  • call 112 / 911 now Heavy bleeding from the stitches
  • see a doctor soon Leaking stool or wind you can't control
  • see a doctor soon Pain, swelling or bad-smelling discharge from the wound
  • see a doctor soon Stool or wind coming from the vagina

Where it strikes

Medical treatment

  • Examination with a rectal check after every birth
  • stitches for second-degree tears
  • repair of the anal sphincter in theatre (third and fourth degree)
  • antibiotics and laxatives after sphincter repair
  • physiotherapy and endoanal ultrasound follow-up

Natural & lifestyle

  • Pelvic-floor exercises in pregnancy
  • ice packs and sitz baths after birth
  • keep stools soft

Emerging & experimental

  • Devices to protect the perineum during birth
  • stem cells and bulking agents for sphincter injury

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Perineal massage from 34 weeks — trials: fewer tears needing stitches in first births trials support
  • Warm compresses during pushing — trials: fewer severe tears trials support
  • Arnica and witch hazel for healing — traditional; untested anecdotal / traditional

ICD codes