Understanding Third-Degree Birth Tears

A Calm, Honest Guide to Healing After a Deep Perineal Tear

Birth is powerful — and sometimes, it leaves more than just stretch marks. If you’ve experienced a third-degree tear during childbirth, you might be feeling overwhelmed, sore, and unsure about what’s normal.

You’re not alone — and you haven’t done anything wrong.
At Neutral Nest, we believe in holding space for the realities of postpartum recovery, not just the soft-focus version. So here’s everything you need to know about third-degree birth tears, healing, and what support is available.

What Is a Third-Degree Tear?

A third-degree tear happens when the skin and muscles between the vagina and anus (the perineum) tear during childbirth, extending to the muscles around the anus.

It’s more serious than a first- or second-degree tear, and less severe than a fourth-degree tear (which also involves the anal canal itself).

Third-degree tears are repaired with stitches, usually in an operating theatre shortly after birth.

How Common Are They?

While they can sound alarming, third- and fourth-degree tears affect about 3–4% of vaginal births in the UK. They’re more likely if:

• It’s your first vaginal birth

• Baby is larger than average

• Forceps or vacuum are used

• Labour was very fast or very long

• You had an episiotomy

• Baby is born in a back-to-back (posterior) position

Remember: it’s not about what you did. This is something that can happen — and it’s okay to feel shocked, sore, or even upset about it.

What Does Recovery Look Like?

The first few days:

• You’ll likely feel pain, swelling, and tightness in the perineal area

• You may be given pain relief, laxatives, and instructions to keep the area clean

• Sitting may be uncomfortable — cushions and side-lying positions help

The first few weeks:

• Stitches should begin to dissolve on their own

• You may still feel soreness or pulling

• Going to the toilet might feel scary — but it gets easier

• Pelvic floor physiotherapy and regular check-ins with your midwife or GP are key to good healing.

How to Care for Yourself

• Keep the area clean and dry
  Rinse gently with warm water and pat dry — avoid harsh soaps.

• Use a peri bottle or jug when weeing
  Pouring warm water over the area while you wee can ease the sting.

• Don’t strain when pooing
  Stay hydrated, eat fibre-rich foods, and use any prescribed stool softeners.

• Rest and lie down often
  Gravity puts pressure on your stitches — horizontal rest supports healing.

• Ask about pelvic floor exercises
  You may be advised to start gentle squeezes once cleared by your midwife.

• Be kind to your body
  You’re healing from both birth and surgery — it’s okay to take things slowly.

When to Reach Out for Help

Call your midwife, GP or health visitor if you notice:

• Worsening pain or swelling

• Foul-smelling discharge

• Fever or chills

• Difficulty controlling your bowels or wind (this may be a sign of damage to the anal muscles that needs further treatment)

These symptoms are not your fault, and they’re worth addressing early.

What About Sex and Intimacy?

You might feel anxious about sex after a third-degree tear. There’s no rush — and no right time. Some people feel ready after a few months, others take longer.

Tips:

• Wait until bleeding has stopped and the area feels fully healed

• Use plenty of lubricant (hormones can make things drier than usual)

• Start slow, go gently, and stop if anything doesn’t feel right

• Talk to a GP or pelvic health physio if pain continues — support is available

Emotional Healing Matters Too

A third-degree tear can feel traumatic. It’s okay to grieve how birth unfolded, to feel angry, or to need space to process it all. You are not weak — you’re human.

Talk to someone if:

• You’re feeling low, anxious, or not yourself

• You’re replaying the birth or avoiding conversations about it

• You feel disconnected from your body or baby

Your wellbeing matters as much as your baby’s. Always.

Final Thoughts

Healing from a third-degree tear takes time — physically and emotionally. But you will heal. And you deserve support, softness, and space while you do.

At Neutral Nest, we’re here for every side of parenthood — not just the tidy parts. You’re not alone. You’re not doing it wrong. You’re healing — and that’s enough.