Perineum healed apart


Hi, everyone!

I gave birth to a beautiful baby boy 5 months ago. It was a semi unassisted water birth and an amazing experience. The midwives allowed me and my husband to birth the baby on our own without any interference. I wouldn't have had it any other way.

However, I had a misdiagnosed tear. I did get postpartum care and they told me it was a first degree. Unfortunately, I checked 4 days later after the swelling have subsided and I am convinced I tore deeply through my perineum and part of my sphincter. It's really depressing for me. Right now, at 5 months, it definitely looks so much better than when I checked at 4 days postpartum, but it's still not totally together. Like there's barely any separation from the vaginal opening to the anus... like it's as if I don't have any perineum left. There is somewhat a separation that looks like muscle and not skin, if you know what I mean. I kept my legs closed together and bed rested, but looks like I should've gotten repaired after birth.

I LOVE my birth, but I can't deny getting really stressed out with the perineum that this birth has left me with! And no, the birth wasn't traumatic. It was actually very calm and peaceful, and I feel like I could do it over and over again. It's just my healing phase that is not so great. :(

Is my risk of getting prolapses going to increase because of this? Have you heard of anyone walking around "perineumless" without any problems? I am now doing the whole woman posture, but it's just because I'm really scared. I want to be normal again, but I'm afraid of having a surgery since I'm not sure if we're done having children.

Right now, I don't even know if I'm walking around without a prolapse. I get really paranoid because of what I read on the internet. My husband tells me to stop researching and just think that I will eventually heal, but I couldn't help it. He tells me that if I read too much, it's gonna cause more problems because I get paranoid. Google actually eats up so much of my time, and if you check my search history, it's mostly "how to heal your perineum naturally."

Ugggghhhh!!! What to do???

Hi askyfullofstars and welcome,
There have been many posts on torn perineums here on the forum. I have read that posture and some salves and treatments can be very helpful for that, but I can't remeber where those posts are at the moment.
Put some different combinations relating to perineum in the search, and you may happen upon them. Otherwise, maybe someone will come along that has more experience with this.
Posture is good for you no matter what you are going through, so keep working on that.
Just wanted to welcome you and hope you can find some answers and relief soon.

I have been searching on here for some relevant posts. Two of our "founding mothers", Alemama and Granolamom, both had tears that were not repaired (this was intentional I believe). I'll keep looking and maybe someone else will chime in. - Surviving

Hi Sky,

This is an area that I and a couple of our older members (alemama and granolamom) with unrepaired perineal tears researched and agonized over for a long time. We finally came to the conclusion after learning how riskly perineal surgery is, and how poor the outcomes usually are, that living with an unrepaired tear is probably the best long-term strategy.

A perineorrhaphy is basically a rectocele repair, with special attention paid to “plicating”, or stitching together, the perineal area. Read here the posts by Blissedout and you will learn of the life-long consequences of these surgeries.

Due to the fact that the circular bulbocavernosus muscles surrounding the vaginal opening can never be truly “repaired” after severing, entire generations of women, myself included, are “walking around perineumless.” In WW posture, we carry the pelvic organs at the front of the body where they belong, and away from the outlet at the back. This is why women benefit from this work, even with conditions such as yours and mine.

Chances are your irregular (un-cut), and probably not terribly deep, tear will heal in time. Every woman should learn that the pelvic organ support system is a postural system - they are one and the same. Hope you can stay out of worry and get on with your beautiful life.

Wishing you well,


Thank you so much for your replies. The midwife actually told me she could repair it, but that it didn't need suturing because it was a small tear. :( I wish I had looked in the mirror. I got this tear probably due to my episiotomy on my first birth 8 years ago. They say scar tissues don't stretch that well, hence this tear. I went back to the same group of midwives 2 months after my birth and asked them to take a look at how things are. They said that they usually let tears heal on their own unless they are profusely bleeding. I wish to go on with my normal beautiful life, but I just really wish I can be normal and fearless again. I never worried about these things years back. Though I must admit, I hate hospital births and anything related to it, because my first birth was so traumatic, but the ones in the hospital were able to preserve my natural vaginal anatomy 8 years ago. It was painful but it looked normal. :(

Oh, it makes sense that you tore so badly. Well, join the perineum-less club. Please understand that I don’t say this lightly, because I know how difficult it is for you. I wish we lived in a world where women were cherished and protected from such senseless acts of violence as routine episiotomy. But the reality of our world is far different.

It seems to me that you have two choices in how you respond to what has been placed in your path. You can spend your days wishing it away and mourning for your younger self. This would include trying to repair the damage with further surgery. That said, I really have no way of knowing whether you might benefit from the cosmetic outcome. I do know that “repair” of a common midline episiotomy results in a thinned and barely-there perineum by the post-menopausal years. Whether they repair it at the time of birth or years down the line matters not.

The other choice would be to summon the rest of your body to strengthen around this injury. You are definitely at greater risk of developing prolapse and urinary incontinence, which no amount of surgery is going to protect you from. The sooner you gain understanding of your true pelvic organ support system, the better your chances are of remaining symptom-free for the long term. You will also feel better when you sense your perineum tightening from proper closure of the pelvic wall. This is a side-to-side closure of the muscles, rather than trying to tighten your vaginal sphincter through kegeling. These forums are filled with women who were once in your shoes and who are joyfully laughing and leaping though their lives - having summoned the deepest aspects of their femininity to rally against “the first cut”.


"perineum tightening from proper closure of the pelvic wall. This is a side-to-side closure of the muscles, rather than trying to tighten your vaginal sphincter through kegeling."

-How do I do this? Thank you for the info.

Hi Sky - Christine is talking about the Whole Woman postural work. - Surviving

Oh, I see. Thanks.

What do you do to avoid getting a prolapse? I don't have one now but I want to completely avoid it.

You may or may not be able to avoid it in the end. Whole Woman posture and lifestyle is what you need to do starting now. I know I wish I'd had this knowledge a few decades ago! - Surviving

hey there askyfullofstars
I dont even remember all the ins and outs of my own history anymore but in a nutshell, my perineum is a mess. I never tore through my sphincter though, so that's a good thing. I've had more babies anyway and it hasnt gotten worse. I dont know if the unrepaired tears are 'why' I developed a prolapse, but that doesnt even matter anymore because my prolapse is well controlled. if you dont have a prolapse now, dont go borrowing trouble, but do read all you can here and adopt the posture, which will be your best bet in attempting to prevent POP.
as christine said, I did toy with the idea of having my tears repaired, but felt that the risk of surgery did not outweigh the benefits.
I will be very honest with you, the worst part of this messed up perineum is the psychological stuff. there is a real loss here, a loss of body integrity, possibly a loss of what you feel is your femininity, or beauty or female strength. it is so many different things to different women, but I do think the commonality is that something feels taken. and that loss, even if you cant pinpoint what it is exactly or why its so important, is real and deserves to be mourned. the grief process has been well studied and defined, and I can tell you that I spent YEARS mourning the loss of my perineum and I did come out the other side with full acceptance. I am healthy and strong. I have birthed more babies with this less than perfect perineum of mine, I've carried them on my back and danced with them in the rain. I'm ok, and so will you be. not the same, but ok. and that is life, none of us get through it unscathed. you will find your new normal, and you can still live a full and happy life. for now its scary, I know that, but maybe you can trust me just a tiny bit..maybe enough to take the edge off the fear..that you will be ok.

congrats on the new baby!

Christine - I truly wish that you wouldn't use people as examples of the consequences of surgery i.e. by naming names! Have you ever thought how very distressing this might be for someone attempting to find self healing measures over several years - I was beginning a response to the lady who wrote so beautifully about mourning the loss of femininity/ integrity of the body etc and was about to ask for women experiencing similar emotions over many years as still compiling data of sorts to finally present to surgeons but hope this hasn't sent as your comments would only serve to increase a sense of hopelessness and mourning! ( rather than hope for better times!) This is your most unhelpful /unchanging problem area Christine - I have mentioned this before but obviously it wasn't taken on board! Please hear my plea! (yes - one is overly sensitive and understandably so I hope!)

Hi Blissedout. I don't know if Christine will see or respond to this post. She does not hang out on the forum, though she does pop on from time to time. The reason I'm responding is to bring your attention to a post you wrote, where you specifically asked her to refer members with post-surgery issues to your account. - Surviving

Yes you are right! In my over sensitivity, I overlooked this! I just feel 'kind of highlighted'- very much like being at school-light years ago, and named as an example! Deep repressed stuff here obviously, but would seriously like to hear of anyone who has experienced this sense of 'mourning' for the loss of the experience of original physicality, even though it was periodically challenging! There are, I have discovered few women to relate to about this issue. What I have deduced from my six year experience is this- better to be the 'natural self' than the contrived one!
Good wishes

Hi all,
I had a 4th degree tear 8wks ago. My stitches came out but i think the wound healed (but healed apart), because i didnt feel any pain at all.
But when i look it up, the skin is still open leaving a gap/hole where i can see the muscle. But again no pain at all. It's just the two sides didnt close up. I guess it's the same as askyfullofstars?
1/3 of my perineum towards the vagina is closed and intact. The 2/3 of my perineum towards the anus is opened on the sides.
Sky, did you experience any pain at all?
Did it hurt when you have sex? I havent had any sex because im too scared it will hurt or even tear further.
Oh since then, im having gas and (sometimes) anal incontinence. Does it mean prolapse?
If you dont mind, please share your experience with me.
Thanks a lot in advance.

I'm following this as I had a suction assist with my first and a cut (not sure what type) and then repair and my perineum felt normal and was high up. Then after my second I tore and was stitched up again (same midwife) and a few days after I tore again (she stitched it too tight) but it was on the side, a little tear shape of red. This healed naturally and at 3 mths PP I got prolapse. It was in the making before I got pregnant but obviously my perineum did not help.

When I read about the muscle and loss of the perineum I get confused. Mine sits low and wide. I think there is enough of it between my anus and vagina but it no longer sits up high rather down low and my rectocele goes in and out of my vagina during the day and during my cycle (stage 2 and 3 I guess).

My perineum is something I do worry about. I got worried again the other night during sex when it got sore (stretching horizontally) and the next day felt lower. This was probably me imagining it. Thanks to WW there seems no damage done but still I do worry about it when I feel it as it's so low. It is not all puckered like I remember it being - this is the loose bit. I distinctly remember it being high with my second pregnancy as I was meant to be rubbing oil into it but didn't that often as didn't like feeling it (I have got over myself since prolapse).

I get confused by the comments about people not having a perineum. I assumed if we have skin muscle, something between the vagina and anus then we had a premium. I just thought mine had gone all loose hence it is low. I have also read that a low perineum is just normal with prolapse.

I don't get anal incontinence but I think a lot of that is because I tend towards constipation (managed very carefully with diet). I think it would be an issue if my stools tended towards being runny or breaking up. Certainly it would be hard to get complete evacuation.

I'm a bit confused and still mourning my perineum. I absolutely shudder to think how I would be without WW.

Hoping you get some answers and relief Joshmom. Midwives should be taught correctly about prolapse then we would not tear in the first place!

I really like Christine's posts above. Well worth reading again.