Your visit to the Perineal Tears Clinic

What is this information about?

This information is about your Perineal Tears Clinic appointment. It explains:

• the reasons why people may be referred (sent) to the Perineal Tears Clinic
• who the Perineal Tears Clinic team are and how they may be able to help you
• how soon after you have had your baby you are likely to have your appointment
• what is likely to happen when you have your appointment
• what might happen after your first appointment.

Why have I been given this information?

You have been given this information because you have been referred to the Perineal Tears Clinic. This is because you have had an injury (wound or tear) to your perineum or anal sphincter.

The perineum is the area of your body between your bottom (anus) and your vagina. The anal sphincter is the muscle that tightens or loosens your anus.

Reading this information will help you to know what to expect from your visit to the clinic.

What is the Perineal Tears Clinic?

The Perineal Tears Clinic is a specialist clinic for people who:

• have a tear to their anal sphincter caused by childbirth
• have a perineal wound which is not healing well
• people who have an infection or on-going pain in their perineum after childbirth

Which healthcare professionals are in the Perineal Tears Clinic team?

The team is made up of experienced specialist pelvic health midwives, physiotherapists and consultants (specialist doctors).

How soon after I have had my baby will you phone me to check how I am?

We will arrange a phone call (phone consultation) with you within three to six weeks after the birth of your baby.

What will you ask me about during this phone call?

We will ask you how well you are recovering and about any bladder symptoms (trouble with peeing), bowel symptoms (trouble with pooing) or pain that you may have.

We will then invite you to come to the Perineal Tears Clinic for an appointment.

What should I expect during my first face-to-face appointment at the Perineal Tears Clinic?

When you have your appointment, the team will:

• ask you about the symptoms that you have and whether these have changed since you had your phone appointment
• explain again what your tear is and how it happened when you gave birth to make sure that you understand.

The team will also offer you an examination (a check-up of how you are and how you are healing). This might include:

• checking your wound to see how well it is healing
• a vaginal examination to check the strength of your pelvic floor. Your pelvic floor is a group of muscles that stretches from your pubic bone to the ‘tail bone’ at the bottom of your back (spine).  

This includes checking that you are doing any exercises that you have been given to strengthen your pelvic floor in the right way. This means we can give you a pelvic floor exercise plan that is right for you.

• an examination of your bottom (your rectum or back passage) to check the strength of your anal sphincter. This is to make sure that it has healed well.
• giving you further information and advice on healing, exercises, future pregnancies and childbirth and starting to have sex again.
• referring you to another team (such as physiotherapy) for specialist help if you need it. We may not know enough about your condition to refer you if you have not had an internal examination.

When will I have another follow up appointment after being seen in the clinic?

If you have had a third or fourth degree tear you will have an appointment three months after you had your baby.

What might happen at my 3-month appointment?

We may:

• check how well you are healing by doing a vaginal or rectal examination
• offer you an endo-anal ultrasound scan. This is a small probe which is placed just inside your bottom (rectum) to see what the muscles looks like and how they have healed.

The consultant will tell you what we found out from doing the examination and scan if you had them. They will also speak with you about any further care or treatment you may need.

If you are ready to talk about future pregnancies and how you may give birth you can talk with your consultant about this at this appointment. Otherwise, your scan information will be saved on your BadgerNet and Evolve record so that it is there for your next pregnancy.

We hope that your visit to the clinic is comfortable, helpful and gives you all the information you need.

Where can I find further information?

The following provide useful information:

• Sussex Maternity and Neonatal System:
  • Advice following a third or fourth degree tear
  • Pelvic floor exercises in pregnancy
• RCOG Perineal tears and episiotomies in childbirth

Who can I contact if I need further information or support after I have read this information?