Perineum – What is it and its importance during childbirth?
What is perineum?
Perineum is the small area between the vagina and the anus in women. Similarly in men, it is the area between the scrotum and the anus. This region is made of thin tissues that act as a barrier between the vagina and rectum inside the body. Perineum has relatively less hair compared to other parts of the genitals.
What happens to perineum during childbirth?
During vaginal childbirth, the muscles and tissues in and around the vagina stretch to facilitate the delivery of the baby. The perineum also takes a lot of pressure during the childbirth process. In cases when the baby is large or if the baby’s head is large, there are chances of perineum tear to occur. Young women or older women by age or women who are obese or overweight are at higher risk of having their perineum torn during vaginal childbirth.
Perineum tear can be avoided to an extent if you give perineal massage during pregnancy and prepare the tissues in the area to stretch. Instructions on how to massage the perineum should be taken from your gynecologist or midwife who will be delivering the baby. The doctor or midwife may even make small incision in the perineum to widen the delivery canal and this procedure is called Episiotomy.

More on episiotomy
Episiotomy is the procedure in which your midwife or gynecologist make a small incision to the perineum to make the birth canal larger. If you are not given epidural or other anaesthetics to numb the area, the area will be numbed first and then the incision would be made.
After delivery, the doctor will look for any other tears and then suture up the tears with dissolvable stitches. During the recovery process, good care needs to be taken if the perineum is sutured.
- Proper clean up is necessary after peeing or passing stools. Keeping the area clean is important to prevent any infection.
- Your doctor will put you onto antibiotics and anti-inflammatory drugs. Follow the prescription religiously until proper healing takes place.
- Avoid sex with your partner until your doctor gives a go-ahead.
- Do not douche or use tampons or any other napkins in the area.
Does the perineum become lose after vaginal childbirth?
Yes, the odds of perineum tissues stretching and tearing are high during the first vaginal childbirth. Post childbirth, the vaginal canal (the muscles and tissues in and around vagina including those in the perineum area) contract and try to get back to previous condition. However, that contraction to original conditions is not 100% and the vagina feels loose. Your partner can easily feel the difference during the intercourse.
Is there a way to tighten the perineum?
Luckily yes. With the introduction and adoption of cosmetic gynecology, the loosened perineum can be tightened and can be brought to near pre-childbirth condition with a procedure called ‘Perineoplasty’.
What is Perineoplasty?
Perineoplasty is a procedure in which the redundant and scarred tissues around the perineum are removed and the area is stitched up with dissolvable tissues. This procedure is done as a day-care or outpatient procedure under local or full body anesthesia. At DG Laser & Cosmetic Gynecology Clinic, Dr. Deepa Ganesh, one of Chennai’s top trained and experienced cosmetic gynecologists uses laser to excise the scarred tissues and excess skin in the area. Usage of laser in performing perineoplasty results in promoting quick healing, minimal blood loss, less post operative complications etc.
What other procedures can help in getting a tighter vagina?
Vaginal Tightening or Laser Vaginal Tightening is one of the several procedures under Vaginal Rejuvenation. Laser vaginal tightening can bring your vagina to near pre-childbirth tightness so that you and your partner can have more orgasmic intimate moments.