There are ways to reduce the likelihood of a third or fourth degree perineal tear. You will have the opportunity to talk to your healthcare team about these options.
- Perineal self-massage (or with help from your partner) after 34 weeks of pregnancy can help protect your perineum and reduce the risk of third and fourth degree perineal tears.
- Pelvic floor muscle training may help prepare you for labour and birth and reduce the possibility of a third or fourth degree perineal tear.
During a vaginal birth:
- Applying warm compresses to the perineum during the second stage of labour can significantly reduce the risk of a third or fourth degree perineal tear
- Slowing the rate at which the baby’s head and shoulders emerge, with the help of your birth attendants, may help prevent perineal injuries
- Perineal massage performed by your healthcare professional during the second stage of labour may reduce the risk of third and fourth degree perineal tears. However some women may not feel comfortable with this option and it is not recommended for everyone.
If there is a clinical need, a member of your healthcare team may suggest an episiotomy where a cut is made in the vaginal opening to help make more space. After the birth, the cut will be repaired with stitches. If you consent to an episiotomy, the cut should be made at the correct angle to reduce the risk of a perineal tear.
Discussing these options with your healthcare team during pregnancy can prepare you to make informed decisions during labour and birth. You will always be asked for your preferences and consent for the care offered to you.