Many women leave hospital having been told they had a second-degree or third-degree tear, without anyone explaining what the number means. That gap leaves some women more worried than they need to be, and others unaware that they should be getting more follow-up than usual.
A first-degree tear involves only skin or the shallow lining. It often heals on its own and sometimes needs no stitches. A second-degree tear extends into the perineal muscle. This is the most common grade and is usually stitched in the delivery room. Both generally heal within a few weeks without long-term consequences.
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WhatsAppLINEThird- and fourth-degree tears are different, because they involve the anal sphincter muscle; a fourth-degree tear extends into the lining of the anus as well. These need repair by a clinician experienced in it and warrant specialist follow-up afterwards, because they carry a higher chance of difficulty controlling wind or stool later on. A woman who has had a third- or fourth-degree tear should know this before a subsequent pregnancy, as it informs planning for the next birth.
At every grade, the signs worth watching for are those that do not fit normal healing: pain that increases rather than settles, an unpleasant smell or discharge from the wound, fever, or new difficulty holding wind or stool. That last group often goes unreported out of embarrassment, even though it is treatable and easier to address early.
See a doctor if perineal pain is increasing rather than improving, if you develop a fever or the wound smells unusual, if you have new difficulty controlling wind or stool after birth, or if you had a third- or fourth-degree tear and are planning another pregnancy.