Third of Fourth Degree Tears During Childbirth (Obstetric Anal Sphincter Injury)

The perineum is the area of skin between the vagina and the anus. During childbirth, the perineum may be cut (episiotomy) or may tear. Small skin-deep tears are known as first degree tears and often heal naturally. Deeper tears are known as second-degree tears and require stitches. A third or fourth degree tear describes a tear that extends into the anus. This will be repaired in the operating theatre shortly after your baby is born.

In the UK, third degree tears occur in about 3% of vaginal births.
Common symptoms of a third degree tear include a sudden urgency to open your bowels, and difficulty controlling wind. A small number of women may also experience faecal leakage, either on the way to the toilet, or after opening their bowels.
60-80% of women with a third- or fourth-degree tear will have no long lasting complications.