Information for Women Following a Third or Fourth Degree Tear

Understanding the causes
In healthy adult women the most common cause of problems with bowel control is damage to the muscles in that area during childbirth. Typical symptoms that might be experienced are poor control of wind, needing to get to the toilet very quickly and leakage of bowel motion. Symptoms can be mild, moderate or severe and may start soon after the birth. Some women, however, do not develop symptoms until much later in life. This is because muscles and other tissues in that area tend to get weaker as we get older. It is therefore a good idea to get the muscles stronger now. If the muscles and other tissues are strong this may reduce or prevent problems later.

Common bowel symptoms include:

• Difficulty controlling wind
• Urgency to reach the toilet
• Leakage of bowel movements

Common urinary symptoms include:

• Leaking urine when coughing, sneezing, or laughing
• Urgency to reach the toilet
• Difficulty fully emptying the bladder

Symptoms can range from mild to severe and may begin shortly after birth or develop later in life. Strengthening pelvic muscles now can help reduce or prevent future problems.

Pelvic Floor Muscle Exercises
To support recovery and long-term pelvic health, follow the guidance in the pelvic floor exercise leaflet. If you haven’t received a copy, please ask your midwife.

Helpful Tips

• Maintain healthy bowel movements: Aim for stools that are firm but soft. Loose stools are harder to control, while hard stools can be painful and may cause further damage. A balanced diet with plenty of fluids is recommended.
• Support the perineal area during bowel movements: Use a maternity pad and your hand for gentle support. Hold the pad over your vagina, with your fingertips resting on the skin between your vagina and back passage. Apply gentle upward pressure through the pad as you open your bowels.
• Adjust your toilet posture: Placing your feet on a small footstool while sitting on the toilet can improve bowel emptying and reduce strain.
• Manage urinary symptoms: Avoid rushing. Pelvic floor exercises can help improve bladder control over time.
• Avoid heavy lifting for at least 6 weeks

Need Support?
Contact the Physiotherapy Department on 01274 365277 Monday and Friday between 8.00am and 4.00pm. Tuesday to Thursday between 8.00am and 5.30pm