Perineal tears
A tear happens spontaneously as the baby stretches the vagina during birth. It is very common to experience a graze or tear of the labia, or more frequently, the perineum, which is the area between your vagina and anus. For most, these tears are minor and heal quickly.
Types of tears
1st and 2nd degree: tears that involve muscle/skin that may require stitches.
3rd and 4th degree: severe tears which extend to the muscles that control the anus (the anal sphincter), requiring stitches. These are also called 'Obstetric Anal Sphincter Injuries' (OASI).
Preventing a perineal tear
A midwife can help you avoid a tear during labour when the baby's head becomes visible.
The midwife will ask you to stop pushing and to pant or puff a couple of quick short breaths, blowing out through your mouth. This is so your baby's head can emerge slowly and gently, giving the skin and muscles of the perineum time to stretch without tearing.
The skin of the perineum usually stretches well, but it may tear, especially in women who are giving birth for the first time.
This discussion guide provides you with information about your personal risk of severe tears and how to reduce your risk in pregnancy and birth: The OASI Care Bundle Information for expectant mothers (rcog.org.uk)
The following animation explains what an Obstetric Anal Sphincter Injury (OASI) is, the four components of the OASI Care Bundle and how women can reduce their risk of sustaining an OASI in childbirth.