A GP guide to higher-degree perineal tears

GPs have an important role to play in minimising the impact of severe perineal tears on women’s lives by providing appropriate care, reassurance and support

Need to know:

  • Women who have had third- or fourth-degree perineal tears need appropriate psychological support.
  • Ongoing care and work with pelvic-floor physiotherapists are essential to recovery.
  • Encourage women to attend specialist perineal clinics even if they are asymptomatic following third- or fourth-degree perineal tears, as future birth risks and pregnancy planning still need to be addressed.
  • Refer women to appropriate specialists, such as a colorectal surgeon, if there are ongoing specific symptoms, such as faecal incontinence.
  • For women considering potential future pregnancies, refer to clinicians experienced in the care of women who have had third- or fourth-degree tears.

Birth is a natural process, and many women give birth without medical intervention.

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