Overview
Tears are graded 1 to 4. First- and second-degree tears involve skin and muscle and are the most common. Third- and fourth-degree tears reach the muscle around the anus and need careful repair.
An episiotomy is a cut made on purpose; it heals the same way.
Symptoms
Common signs:
- Pregnant or recently gave birth: pain or soreness between the vagina and anus
Less common
- Stinging when peeing
- Pain with sex later
Look up a symptom: Pregnant or recently gave birth
When to get medical care
Causes
Stretching of the tissue as the baby is born.
Who is more likely to get it
- First vaginal birth
- Large baby
- Forceps or vacuum delivery
Possible complications
Diagnosis
Your care team checks and repairs tears right after birth.
Questions you may be asked
- Pain, bleeding, or trouble controlling gas or stool
The exam
A check of the stitches at your postpartum visit.
Treatment
Most tears heal well with simple care.
Self-care
- Use a peri bottle: rinse with warm water after peeing
- Cool packs: in the first day or two
- Sitz baths: shallow warm water soaks
- Prevent constipation: fluids, fiber, and a stool softener if advised
Medicines
Medicines that may help:
| Medicine | Helps with | Good to know |
|---|---|---|
| Pain relievers | Soreness | Safe for most people who breastfeed; ask first. |
| Stool softener | Easier bowel movements |
OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.
Pelvic floor physical therapy helps with pain, leaks, or tight muscles later.
Prevention
These may lower the risk:
- Perineal massage in late pregnancy
- Warm compresses during pushing
Which doctor treats this
- Urgent care or the ER can treat it first. For minor problems, your primary care provider can help.
- They may send you to an OB-GYN or midwife; high-risk pregnancies may see a maternal-fetal medicine doctor.
- A physical therapist can help with exercises to rebuild strength and motion.
Back to school, work, or sports
- School or desk work is often OK within days. Jobs with lifting may need light duty for a while.
- Go back to sports only when your doctor says it's OK and you have full motion and strength without pain.
Outlook
Most tears heal fully. Deeper tears need follow-up.
Getting ready for your visit
Bring a list of your symptoms and medicines.
Questions to ask
- What degree was my tear?
- When can I exercise and have sex?
Research studies
Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.
Search ClinicalTrials.gov for studies on Tearing during birth (perineal tear)
Sources
Last updated 2026-11-12.