Perineal trauma and childbirth: Expert insight on treatment

Written by: Ms Sameena Muzaffar
Edited by: Sophie Kennedy

In this informative guide, revered consultant obstetrician and gynaecologist Ms Sameena Muzaffar sheds light on the short and long term effects of perineal trauma sustained in childbirth, and answers commonly asked questions, including how this type of injury is managed and treated. The leading specialist also shares expert insight on whether future vaginal deliveries are possible for women who have sustained perineal trauma.

What is perineal trauma?

Perineal trauma refers to the tearing of the perineum during childbirth.

What are the short-term and long-term effects of perineal trauma?

The effects of perineal trauma depend on the degree of the injury. If it's a first or second-degree tear that doesn't involve the muscles of the back passage, you might experience pain and discomfort for up to six weeks. Your sutures may break down, prolonging the healing process and potentially leading to infection. This might result in pain during bowel or bladder movements.

If you have trauma that involves muscles of back passage (third degree tear), you may have bowel problems in addition to above. You may need to rush to open your bowels and you may not have good control on faeces and flatus.

Will I be able to have a future vaginal delivery?

Whether or not you'll be able to have a future vaginal delivery depends on the type of tear you have sustained and how you feel. Your midwife and doctor will discuss delivery options. However, the majority of women who experience perineal trauma can go on to have a normal vaginal delivery in the future.

How is perineal trauma treated and managed?

After delivery, a midwife or doctor will examine the area and suture the perineal trauma to facilitate healing.

What other support is available?

Postnatally, a midwife will conduct a check-up. If any concerns arise, the midwife may request a doctor's review. In the case of a third-degree tear, a follow-up appointment will be scheduled to monitor healing and recovery. Additionally, you'll be referred to a physiotherapist for pelvic floor exercises.

If you wish to schedule a consultation with Ms Muzaffar, visit her Top Doctors profile today.

By Ms Sameena Muzaffar
Obstetrics & gynaecology

Ms Sameena Muzaffar is a highly trusted and respected consultant obstetrician and gynaecologist, based in Winchster. She currently practises at Sarum Road Hospital and Royal Hampshire County Hospital. Ms Muzaffar treats a wide range of gynaecological issues and is a well known expert in managing patients with urinary incontinence, vaginal prolapseperineal tears, painful sexual intercourse following childbirth and menstrual problems

Ms Muzaffar completed her postgraduate training in Wessex Deanery and her MSc in quality and safety in healthcare at Imperial College London with distinction. She holds a keen interest in research and audit and her work has been presented both nationally and internationally.
She also treats patients suffering from bladder pain, cystitis, recurrent urinary tract infection (UTI) and vaginal ring. She is considered to be an expert in pelvic reconstructive surgery including Z plasty in Hampshire and currently holds the role of lead for perineal trauma at childbirth at Hampshire Hospitals Foundation Trust.

In addition to her interest in research, Ms Muzaffar thrives in educating her peers as the organiser of a national study day for the management of third and fourth degree tears, as well as a perineal care study day.
She is the winner of multiple medical awards, including the Innovation Prize from the King’s Fund for enhanced recovery in obstetrics in 2010 and the prize for Best Oral Presentation at The European Congress of Gynaecology in 2011. Furthermore, she was recognised as a gold medalist from Kashmir University and awarded Best Outgoing Graduate of 2002 by the President of India.
Ms Muzaffar is a member of several medical organisations including The Royal College of Obstetricians and Gynaecologists (RCOG) and The British Society of Urogynaecology (BSUG).

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