Perineal Laceration Repair or Obstetric Tear Repair

Perineal Laceration Repair (Obstetric Tear Repair)

A perineal laceration repair is a procedure done after childbirth to close and heal a tear in the tissue between the vaginal opening and anus (the perineum). Tears can also involve deeper layers, like the pelvic floor muscles, and in more severe cases, the anal sphincter. Repair is typically performed by an OB/GYN or qualified clinician soon after delivery to support proper healing and comfort.

Key takeaways

• Most repairs are done right after birth and use dissolvable stitches.

• Recovery is very manageable with good pain control, hygiene, and rest.

• More severe tears need closer follow-up and careful bowel care.

• Supportive postpartum aftercare can make a big difference in comfort and healing.

What causes obstetric tears?

Perineal tears can happen during vaginal delivery due to stretching and pressure as the baby is delivered. Risk factors can include a rapid delivery, a larger baby, use of assisted delivery tools, or a baby’s position during birth.

Types of tears (grades)

Clinicians often describe tears by degree:

• 1st degree: Skin only

• 2nd degree: Skin + perineal muscles (most common that require stitching)

• 3rd degree: Extends into the anal sphincter muscle

• 4th degree: Extends through the anal sphincter into the rectal lining

The degree helps guide repair technique, pain control, and recovery planning.

How the repair is typically performed

Most repairs are done shortly after delivery. The area is cleaned, numbed (or managed with existing epidural anesthesia), then closed with dissolvable sutures in layers. For deeper tears, the clinician may repair muscle structures more carefully and may recommend additional follow-up.

What to expect after the procedure

It’s normal to have:

• Soreness, swelling, bruising

• Stinging with urination (especially in the first days)

• Tightness around the stitches

• Discomfort when sitting or changing positions

Many patients feel noticeably better after the first week, but full healing can take longer depending on tear severity.

Recovery timeline (general guide)

First 48–72 hours

• Swelling and tenderness are highest

• Ice packs, rest, and consistent pain relief help most

Week 1–2

• Sitting becomes easier

• Stitches may feel itchy as healing starts

Week 3–6

• Tissue continues strengthening

• Follow-up visit is common around this time

Beyond 6 weeks

• If pain, pressure, or incontinence symptoms persist, further evaluation is important

(Healing time varies, especially for 3rd/4th degree tears.)

Comfort and healing tips (safe basics)

These are common, clinician-approved supports (always follow your OB’s instructions first):

• Peri bottle rinses after bathroom use + gentle pat dry

• Scheduled pain control as recommended

• Stool softeners and hydration if advised (especially important for deeper tears)

• Avoid heavy lifting and prolonged sitting early on

• Supportive positioning when feeding baby (pillows, side-lying options)

• Pelvic floor rehab when cleared by your provider (often helpful after healing begins)

How Pearl Wellness Center can support your recovery

If you’re recovering in a private, restful setting, aftercare can be focused on comfort, monitoring, and reducing stress while you heal. Depending on your care plan and medical clearance, support may include:

• Private duty nursing support (vitals checks, comfort monitoring, coordination with your OB)

• Incision/stitch-area support education (safe hygiene routines and comfort setup)

• Pain-management support planning (schedule tracking, gentle comfort measures)

• Hydration and nutrition support to promote healing

• Rest-forward environment so you can recover without handling everything alone

• Care coordination for follow-up visits or pelvic floor referrals when appropriate

Note: Pearl Wellness Center supports recovery and coordination; your repair itself is performed by your delivering provider or surgeon.

When to contact your doctor urgently

Seek medical advice right away if you notice:

• Fever, chills, or feeling unwell

• Increasing pain instead of improving pain

• Foul-smelling discharge, pus, or worsening redness

• Heavy bleeding or sudden swelling

• Trouble controlling gas or stool (especially after 3rd/4th degree tears)

• Severe pain with bowel movements or inability to pass stool

FAQs

• Does the repair use stitches that need to be removed?

  Most repairs use dissolvable stitches that do not need removal.

• How long does pain last? Many people feel a big improvement within 1–2 weeks. Deeper tears can take longer and may require closer follow-up.

• Can I sit normally after a tear repair? Yes, but you may need support early on (pillows, side-lying rest, breaks from sitting).

• What helps bowel movements feel less scary after repair? Hydration, fiber, and stool softeners (if your doctor recommends them) are commonly used—especially for deeper tears.

• Will this affect intimacy later? Many people return to intimacy comfortably after healing and clearance. If pain persists, pelvic floor therapy and follow-up care can help.