These most likely occur with big babies, precipitant labors, babies with poorly flexed heads and when forceps are used to deliver the baby.
Perineal tears are classified by the degree of damage caused.
Tears of the labia majora. These are common and can be very uncomfortable, but heal quickly and suturing is rarely required or helpful.
SECOND DEGREE TEARS
These lacerations involve perineal muscle and if severe may involve the anal sphincter. They are repaired in a similar fashion to repair of episiotomy.
THIRD DEGREE TEARS
Extensive damage may even extend into the rectum. Repair is generally carried out, by an experienced obstetrician, under epidural or general anesthesia. Patients must avoid constipation post-operatively by using a high-fiber diet and stool softeners.
Mind you, more of episiotomies do notreduce the incidence of perineal tears.