Severe Perineal Injury

Your perineal body is the portion of skin between your vagina and anus. During a vaginal delivery, the vagina and perineal tissue are stretched as your baby’s head passes through.

WHAT ARE THE TYPES OF PERINEAL TRAUMA?

1st Degree - Injury to the perineal skin and/or vaginal mucosa

2nd Degree - Injury to perineal muscles but not the anal sphincter

3rd Degree - Injury to the perineum involving the anal sphincter complex

4th Degree - Injury to the perineum involving the anal sphincter complex and anorectal mucosa

HOW OFTEN DOES IT OCCUR?

For all vaginal deliveries which occur, only 3% of women experience 3rd of 4th degree tears.

RISKS FOR PERINEAL INJURY

• Asian ethnicity

• First delivery

• Birth weight >4kg

• Prolonged stage 2 of labour

• Instrumental delivery without episiotomy

HOW DO YOU TREAT SEVERE PERINEAL INJURIES?

Following the delivery of your baby, your medical team will discuss with you the extent of your injury and how to care for it. This will include:

• Horizontal rest. This will assist in reducing swelling and discomfort.

• Ice for pain relief and swelling management.

• Use of compression/supportive underwear to reduce swelling.

• Pelvic Floor Muscle exercises. This will help to improve circulation, promote healing, and strengthen the pelvic floor muscles.

• Prevent constipation. Straining on the toilet can increase pressure in the area further. Stool softeners, fibre-rich foods, and adequate fluid intake can help to prevent constipation. Always follow your medical teams advice on the best treatment for you.

FOLLOW UP APPOINTMENTS

After severe perineal injury, its crucial to attend a follow-up appointment with your pelvic floor physiotherapist to ensure you regain good functional strength, and that there are no long-term complications, like incontinence or pelvic organ prolapse.

If you’ve experienced perineal injury or wanting to reduce your risk, click here to book in your appointment or get in touch hello@scencephysiotherapy.com.au.