2nd degree tear
This tear goes
into the vagina,
in the perineum
(the outside skin
between the vagina
and the anus),
and in the muscle
under the skin.
Sewing a tear or episiotomy
3rd degree tear
This tear goes
into the vagina,
the perineum,
the muscle, and the
rectal sphincter
(the muscle
around the anus).
2nd degree tears will heal better
and are less likely to become
infected if they are sewn, but
they can heal on their own.
3rd and 4th degree tears
must be sewn. If possible,
they should be sewn by
someone very experienced.
4th degree tear
This tear goes
into the vagina,
the perineum,
the muscle, the
rectal sphincter,
and into the
rectum.
4th degree tears are very difficult
to repair. If a mother has a
4th degree tear through her
rectum, get medical help right
away.
To test if the muscle
around the anus is torn
Lightly brush
the anus with
a gloved finger.
If the anus
tightens, the
muscle is
probably OK.
If the anus does
not tighten, the
muscle may be
torn.
After you do this test, throw your
glove away or sterilize it, and
wash your hands well.
357
A Book for Midwives (2010)