What is a Perineal Tear and Episiotomy?

Despite the fact that childbirth has occurred since the inception of mankind, we know that it may not be as straightforward in some situations. Perineal tears and episiotomy are common with vaginal birth and can contribute to pain, bladder and bowel control problems, and sexual difficulties.

You might find yourself having difficulty with simple things like sitting, and unable to enjoy social activities or intimacy.

The pelvic floor muscles attach from the pubic bone in the front to the tail bone at the back, much like a sling. These muscles play an important role in sexual, bladder and bowel function. A well functioning pelvic floor can contract and relax. Following pregnancy and a perineal tear or episiotomy your pelvic floor may be weak or too tight. And if you are constipated, this can just make things a little more uncomfortable.

Image: mypfm.com



  • Grade 1- Laceration of the vaginal mucosa or perineal skin only
  • Grade 2- Laceration involving the perineal muscles (this is equivalent to an episiotomy)
  • Grade 3- Laceration involving the anal sphincter muscles, being further subdivided into
  • 3A- where <50% of the external anal sphincter is torn 3B- where >50% of the external anal sphincter is torn
  • 3C- where the external and internal anal sphincters are torn
  • Grade 4- Laceration extending through the anal epithelium (resulting with a communication of the vaginal epithelium and anal epithelium)


Evidence shows that you can successfully treat these problems through a personalised pelvic health program designed and managed by a Women’s Health Physiotherapist.

I often say to patients that if your wound hasn’t healed within the first 6-8 weeks, to discuss it with your Gynaecologist/Obstetrician and ask for a referral to a Women’s Health Physiotherapist.

Your Physiotherapist will:

  • Perform a thorough assessment which in most instances will involve a pelvic floor examination.
  • Provide advice on management which may include hands-on therapy on the tear or wound, ultrasound, massage, and stretching techniques.
  • Help teach you how to wee (voiding dynamics) and poo (defecation dynamics) better.
  • Prescribe a pelvic floor muscle training program to strengthen the sphincter and pelvic floor muscles.

It may take 4-6 sessions to see an improvement. Motivation and adherence are important factors in achieving your goals.

Many women experience a perineal tear or episiotomy during labour. However, pain and bladder and bowel problems after delivery are not normal. Remember, help is available.

If you are recovering from a perineal tear or episiotomy and require care, please call/WhatsApp on 9780 7274 or get in touch over email to book an appointment or discuss your concerns.

You can also visit our website to learn about other women’s conditions we treat through physiotherapy and how we can help you.


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I had a wonderful experience with Brenda throughout my post partum recovery. She is very friendly and experienced and it definitely shows as she is able to make me feel at ease and comfortable as she navigates me through the exercises and steps to get me back to where I want to be. Appreciate the help and for making it easy especially with motherhood alr being a challenge. Thanks 🙂

Liying Ho Avatar Liying Ho
March 31, 2022

Was recommended by a friend to embrace physiotherapy, I was having bad recurring blocked ducts/mastitis and was desperate. I’m served by a very welcoming and friendly counter lady (forgot to get her name) and my therapists Preet and Brenda are very professional and helpful, they helped get my stubborn blocked ducts cleared in 3 sessions. Preet also referred me to someone who helped with the recurring mastitis. Will probably still experience the same problem if I haven’t visit them, super thankful for the help!

Kate Oxyz Avatar Kate Oxyz
September 2, 2022

I highly recommend Preet & Embrace Physiotherapy. It took me wondering if this was as good as it gets after my first birth to find her and book an initial appointment. I'm very happy to share, NO, it gets much better when you have professional expertise and knowledge to guide you on your post-natal (and pre-natal) journey. I'm more aware of my body and what it's capable of after working with Preet. I'm also aware of what is normal/abnormal for post-natal women. I felt listened to, cared for, and really appreciated the straight-up information. If you're out East or near - this is the women's physio for you!

Jemma Hooykaas Avatar Jemma Hooykaas
July 13, 2021

Embrace life. Embrace Physiotherapy.

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