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Perineal trauma refers to any trauma to the perineum during birth and includes perineal tears, obstetric anal sphincter injuries and episiotomies. The perineum is the area of skin between the opening of the vagina and the anus that connects with your pelvic floor muscles and it stretches to make space for your baby during a vaginal birth. It can also tear, especially if your baby is in a difficult position, your baby is born quickly or you require instrumental assistance – either forceps or vacuum. Severe perineal tears aren’t common – in Australia, roughly 3% of women birthing vaginally will have a 3rd or 4th-degree tear. Around 24% of women will have an episiotomy.