4 Degrees of Perineal Tears (Plus 4 Things You’ll Need!)

Aaaagh the  pain

A simple, homemade ice pack can make all the difference in the world to sooth a healing perineal tear

Perineal, or vaginal tears, can occur during a vaginal childbirth. Childbirth, if you think about it, is a pretty traumatizing ordeal for your peri area.  

At no other time is it stretched to such an unbelievable limit, so it is no wonder that tearing is so common. 

Perineal tears are not created equal; some are minor little tears that heal quickly, while others are more severe and require a lot more time and TLC.  Medical professionals categorize perineal tears into four different degrees.

MORE:  New Episiotomy Guidelines – Why ‘A Little Snip’ Can Be Bad }

Below is a description of each:

4 Degrees of Perineal Tears

  1. First Degree
    These tears are the ones we all hope for – the skin around the vaginal opening is really the only skin that tears, allowing for a quick and easy recovery.
  2. Second Degree
    A little more tearing is involved in a second-degree tear, which actually tears into the perineal muscle. Some stitches are required in this case; but luckily, healing time is relatively quick.
  3. Third Degree
    After the tearing of the vagina, the perineal muscle, and the around the anus will tear. The healing time for third-degree tears can take many, many weeks.
  4. Fourth Degree
    This entails a tear that reaches from the vagina all the way down to the rectum, making this the most brutal of all tears.  Surgery is usually necessary to repair fourth-degree damage, and the healing time can take up to several months.


4 Things You’ll Need

Tearing is uncomfortable and painful.  If your tears fall within the more severe categories, then you’ll, of course, follow the guidelines set by your doctor or surgeon. If your tears are of less severity, here are some basic things you’ll want while you’re healing:

  1. A Peri Bottle
    Make sure the hospital gives you one of these – it’ll calm your fears in the bathroom. Using the restroom after childbirth is a messy business; and it’s uncomfortable.  A peri bottle is meant to be filled with warm water and used to gently wash away blood, urine, and fecal matter from your very sore nethers.
  2. Tucks
    This product, or any other pad medicated with witch hazel, is gentle and will help you heal. After you have cleaned your peri area, simply place a Tucks where you are torn. These are wonderful at soothing away soreness.
  3. A Cool Compress
    A simple, homemade ice pack can make all the difference in the world to sooth a healing perineal tear. Fill a ziplocked, snack-sized baggie with a little alcohol, and place it in the freezer. When it’s ready, wrap it in a soft, clean cloth, and place it in your underwear, just like you would a maxi pad.
  4. A Padded Seat
    Whether it’s a donut or a soft place to sit, you’re going to need something comfortable to sit on.

Your body is going to need some time to rest, and your tearing is going to need some time to heal; so take it easy, and follow your doctor’s orders to ensure the best recovery from perineal tears.

What do you think?

4 Degrees of Perineal Tears (Plus 4 Things You’ll Need!)

Tell us what you think!


  1. Candice says:

    I ripped and had to have many many stitches and the soreness was awful but the ice and squirt bottle are life saver. If you tear trust me don’t be superwoman ask for help or it just takes longer to heal. Now is not the time to be shy to ask for help.

  2. Alycia says:

    Well that sounds pretty brutal. I hope I’m a lucky one and don’t have to deal with severe tears!

  3. emily says:

    I had a third degree tear, and with some cautious aftercare I didn’t even need stitches. The vagina is capable of amazing things. If you’re a first time mom reading this, don’t freak out! You will be totally ok. You’ve got this mommas!

  4. Bri says:

    I hope and pray I don’t get 3rd or 4th degree or any at all tears. The peri area is just really sensitive when you think about it.

  5. Michelle says:

    i have dealt with thrush while being pregnant.. I Know how it feels to be super sore and sensitive down there. What helped me with that was using a gentle face wipe with all natural ingredients down there to alleviate the pain. Im hoping that i wont have tears.

  6. tamie says:

    I cant even begen to relate to what those are I have a flat pelvis and cant have my babys vaginaly in a way kinda of glad

  7. I had to be cut with my first delivery but I only got 3 stiches but I was in hard labor for 12 hours straight and once the head came out I couldn’t do anymore the doctor I had was a rude one and said well if you don’t push then I’M going to have to cut you I yelled GO AHEAD and then my mom and my boyfriend pulled me up and out he came. Wasn’t to bad as long as I had my little squirt bottle I was good to go…

  8. They’re not so bad…I had a 2nd degree, or maybe in between 2nd and 3rd. I was really freaked out about getting a tear before birth. The stitches were done so quickly…I was already holding my little bundle when they informed me I had torn a little, but at that point I couldn’t feel it, and it didn’t seem so bad. They recommended extra strength ibuprofen and “ice diapers” (you take a diaper, slice the back netting open, and put ice cubes in the space between, then put the diaper in your underwear). Sounds weird, but it worked like a charm and very soothing! They also gave me a little squirt bottle (kind of like a condiment squeeze bottle) to rinse instead of TP when using the bathroom, which also helped. The tears sound scary–and I would NEVER want the 4th degree–but honestly are not so bad, especially once you have your little bundle of joy. If you’re not sure how to do an “ice diaper,” ask a nurse or check online. 🙂

  9. edelmira says:

    my baby due date is approaching fast im so worried and don’t know what I can do to relax

  10. edelmira says:

    Im baby due date is approaching fast im so worried and don’t know what I can do to relax

  11. Lynna says:

    I have been frightened with the thought of tearing down there.

  12. Carissa says:

    This article was helpful. Hopefully my birth won’t be horrible.

  13. Kelly says:

    Hi Casie, I am a mom to four girls. I had all vaginal births, I can tell you that having a baby changes everything, For the most part. I opt to be cut with my first and with the others there just wasn’t time to think about it, so I tore with those three. To be completely honest, there isn’t much difference down there. I have a scar and it is barely noticeable. I can also tell you I really didn’t see much difference in having been cut or letting it tear naturally. The healing was the same and so was the time it took to heal. I didn’t have much pain and within a week or so I was all healed up and getting back to normal. The vagina is an amazing organ, it does an amazing feat and returns to normal in a relatively short amount of time. Muscle tone definitely helps with recovery time and I also think genetics plays a part in that too. If your skin had good elasticity and heals quickly……you should be just fine. My advice is to talk with your doctor. They can answer any questions and address any concerns you may have. Good luck

    • Hi Kelly. Thank you for always sharing such helpful advice and encouragement. We are very happy to have you as part of our community.

      • mommy nhoj says:

        Indeed it is an encouraging advice for first-time mom-to-be in the site. I did not experience this with my first and I don’t know if doctors will permit vaginal birth next time. But these information are helpful in any way

  14. Casie says:

    Will you ever be the same down there or are you forever changed?!

    • If you tear, it just makes you a little more like to tear again (they tend to cut then so they can control it), but you go back to looking and feeling normal. The 4th degree can have complications afterward I have heard, but the first 3 are minor and you will go back to normal. (most women only get 1st or 2nd degree)

  15. jessica says:

    … makes me kind of nervous… 10 weeks to go, my daughter was a C-section… so I am nervous and not sure what to expect…

  16. thank the lord for epi’s

  17. naomi says:

    One of the reason child birth scares the crap out of me.

  18. AppleMuffins says:

    This is not accurate! I had a 4th degree laceration and surgery was most definitely not needed. Many stitches, yes, but no additional repairs outside of immediately after child birth. Maybe some tears of this degree require surgery, but this article scares people into thinking you WILL need surgery if you have a 4th degree tear. I am not quite 4 months post partum and I am mostly healed. Every now and then I have a little pain, but nothing major. At my 6 week postpartum check, I was told it was healed up wonderfully and you couldn’t even tell it was ever an issue. I know there are also stories where it did not go so smoothly, but the same can be said of 2nd degree tears. People need to stop scaring women about child birth!

  19. Terra says:

    OMG!!! Good job on scaring a first timer…

  20. acire11 says:

    As horrible as this all sounds, its best to be prepared 🙁

    • Ronnie says:

      Yes I wasn’t prepared. I should of done perineal massages during my pregnancy I was almost a forth degree tear. Luckily my delivery went easy only problem he came out too fast.

  21. Aurika says:

    I had episiotomy with my 1st and recovery was easy. I really hope to not tear at all or have an episiotomy this time. Last time I started pushing too early.

  22. gfeld says:

    Worst tears happened by my first child. It took many stitches and a good two months to heal. By my second I only needed two stitches. By the other 3 no stitches were needed.


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