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Third and fourth degree tear

Tears are common in women having a vaginal birth and range from small nicks and abrasions to deep lacerations affecting several pelvic floor muscles. A tear that also involves the muscle that controls the anus (the anal sphincter) is known as a third-degree tear. If the tear extends further into the lining of the anus or rectum it is known as a fourth-degree tear. Overall, a third- or fourth-degree tear occurs in about 3 in 100 women having a vaginal birth. It is slightly more common with the first vaginal birth, occurring in 6 in 100 women, compared with 2 in 100 women who have had a vaginal birth previously.
  • Speciality Obstetrics 
  • Urgency urgent, emergency 
  • Duration 30 min  to 1.5 h
  • Blood Loss 500 ml  to 2 litres
  • Anaesthesia Regional Anaesthetic - Epidural top-up, Regional Anaesthetic - Spinal 
  • Anaesthesia II Epidural top-up, Local Anaesthetic, +/- Nerve Block 
  • Pain mild-moderate (++) 
  • Hospital Stay 1   to 3 days
  • Full Recovery 4   to 8 weeks
  • Additional Info Many women experience tears to some extent during childbirth as the baby stretches the vagina. Most tears occur in the perineum, area between the vaginal opening and the anus (back passage). Small, skin-deep tears are known as first-degree tears and usually heal naturally. Tears that are deeper and affect the muscle of the perineum are known as second-degree tears. These usually require stitches. An episiotomy is a cut made by a doctor or midwife through the vaginal wall and perineum to make more space to deliver the baby. 
  • More Information Royal college of Obstetricans and 
  • created by Dr Agata Kapuscinska 

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