Slide show: Vaginal tears in childbirth
Illustration of a fourth-degree vaginal tear
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Fourth-degree vaginal tears are the most severe. They involve the perineal muscles and anal sphincter as well as the tissue lining the rectum. Fourth-degree tears usually require repair in an operating room — rather than the delivery room — and might take months to heal. Complications such as fecal incontinence and painful intercourse are possible.

Your health care provider will evaluate your recovery at your postpartum checkup. If you experience complications from a severe vaginal tear, you might be referred to a urogynecologist, colorectal surgeon or other specialist.

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