How to prevent tearing?

[BekZ]

Hi Ladies,

I would like some ideas/tips about preventing tearing. I tore with both girls in different places and I would love to prevent it this time.

Thanks

[Fleur]

Hey Bekz...

i tore with DD (well, grazed, whatever that is) and not DS1.. can't say I actively did anything to avoid it though I think I was just lucky.

However suggestions I have heard of are

- massaging perineum with evening primrose oil or other oil in the last few weeks - from what I understand involves basically massaging & very gently stretching the perineum with oil

- 'breathing' bub out, rather than forcing it - panting & letting the urge to push overtake you, rather than forcing it

- position I think is important too - FWIW I was on my back with DD, all fours with DS1

I think there are some good threads here on avoiding tearing, sorry I don't have more definitive advice! hopefully someone else can clarify or expand on these things I have heard?

Anyway HTH even if just a little

[visitor1]

Im no help hun...ive torn 3 times now..LOL

GL with the up coming birth

[LimeSlice]

Use 1 drop of Rose oil (you will not be able to find or afford lol this as a pure essential oil, it is usually sold as a 3% solution) on your perinium, and massage, you can find instructions on perinial massage easily. Start at around 33 weeks and the oil helps to soften the perinium and prepare it for birth.

Good luck!

[mbear]

I didnt tear with #2,3 or 4.....

#4 is fresh in my mind....i remember when his head was out, i had to wait for the next contraction in order for his body to slide out...but midwife said to me "dont push in next contraction, its gonna be hard, but dont push, if you push, you will tear. YOu will have your baby after the next contraction". It was like someone saying 'dont look but theres brad pitt.". How could i not push !!!! ##)*)*)(*. Anyway, i set my mind in some spec mode, and i thought about anything and everything EXCEPT pushing. Bec, it was the hardest thing ive mentally ever had to do, but i didnt push.....even though every ounce of my body wanted to. And.....i didnt tear. Breathing was really important too.

Good luck.

[Glamourcide]

Try and slow things down as you approach the end!! I birthed both mine flat on my back, with DD1 I had a few grazes but DD2 popped out after only two pushes and I wasn't even swollen afterwards. The best advice I can give is that you try and avoid an epidural or other painkillers, gas is fine because you can still feel everything and you will 'know' when your perineum is at its limit and needs a few more minutes to stretch, if that makes sense? The burning sensation as baby is crowning is horrible, but just try to breathe through it knowing that it will only last a little while longer. I had a midwife telling me to keep pushing but I just knew I needed a bit more time, I held myself back (as hard as it was!) and waited until the next contraction, and with that one I just bore down a tiny bit rather than straining at it.
Once her head came out, I laid back and told the midwife to do the rest of the work (pull her shoulders out)

I've heard the perineal massage works wonders too but I didn't do it with either birth, I'm probably just lucky but trying to slow things down, and staying unmedicated (I had gas, but nothing that totally killed the sensation) in order to let me feel when my body was ready worked for me. HTH Good luck this time!

[dust]

have not torn.. (no stitches) but did have slight grazing (labia minora tore a lil bit horizontally, that apparently is a graze in the public health system..)
I had no complications(very blessed) & used no pain killers. Ive used a birthing bean bag with bub#2(on all fours) and was vertical (on my knees) for bub #1. Breathing helps... i had burning sensation with my 1st. She crowned and stayed there for awhile which is good.. but ow!! With my 2nd she crowned and i had no ability not to hold her back, it felt like they(midwifes) were pulling her out of me (but they weren't), it happened so quickly!

theres the EPI-no (a device to aid in the stretching in the weeks pre-labour), massage, use of a warm wet cloth during labour (support person or midwife applying pressure) something i read alot in those silly baby/birth magazines.

gl with it all!

[BekZ]

Thanks for all your wonderful and helful replies.

With DD1 I got that burning feeling and I successfully got her head out without tearing. Then I didn't listen to the middy who told me to wait and instead I gave an huge push. DD turn her shoulders and I spilt from one end to the other. With DD2 I didn't get the burning feeling at all and I pushed so hard that she popped out head and body all at once and my tearing was internal.

I think I'll talk to my middy and make sure that they are aware that I want to prevent tearing where possible.

MBear - I'll think of Brad Pitt when I'm holding on that contraction..lol

GothMum - Thankfully I haven't required any form of pain relief either, and I am hoping to keep it that way. However, my last labour I was determined that I was going to push hard and fast (after my first birth that was 2 hours of pushing)!!! Seems I went too hard

Jasp/Lime - I'm off to google perinial massage.

Lilmunchinkins - Thanks babe

[Inanna]

MBear thanks to you I burnt my boobies by choking on tea! Maybe it's a good line to tell a woman in labour : "Look lovey it's Brad Pitt"... Sorry it tickled my funny bone.

Bek it's great that you are asking - there is a lot said about tearing and prevention - I don't see it as a preventable thing - yes manageable but not always preventable.

If you have a fast labour it can mean you will tear or it can mean you won't. In my personal experience my labour with a 3hr + second stage tore 2nd degree. My daughter at nearly 10lb born in an hour of labour give or take I had a teeny graze.

Utilising water minimises trauma to the perineum so if you can use a bath or tub that's great. Prone position statistically causes the most likely chance of tearing. So get up, move, squat to help that peri stretch. There are schools of thought about using perineal stretching - some say it works some say it makes no difference. I say, it can't hurt. Olive oil is fine - sweet almond oil is another of my favorites. Using fingers to gently stretch until you get that burning feeling is a good way of getting to know your body - and if it helps to prevent trauma that's great.

To be honest once a Woman gets to the point where that head is crowning it is my personal opinion that she follow those instincts. I cannot hold back myself & just go with my body. That may be an option for you. I don't believe in too much coaching in labour. Going with your body and it's rythums usually is a positive thing. Tearing is not the end of the world - yes it hurts and obviously it's better not to - but if you do there is much that can be done to help you heal. I add the caveat that obviously if a baby's position is such that clearly damage is going to be done to the mother this is a different kettle of fish. My comments pertain to birthing a baby in a position that is not going to cause obvious and great trauma...

There is also a school of thought that believes a tear is (usually see above!) better than an episiotomy - I am of that school!

Bek you are going to birth this baby girl beautifully - all my love darling...

[MamaPan]

I am also of the thought that a tear is usually better than an episiotomy..
i had 2 deg tear last time but my ob seems to think this means i am less likely to tear this time (or is he trying to make me feel better?). i mean to do per massage last time, did a little... this time i havent yet but i might give it a go - it cant hurt!
there are some good ideas here... thanks ladies. Mbear maybe i will add a pic of brad to my labour bag!

[~Raven~]

Try and resist being coached to push as much as possible (unless bub is in distress and needs to come out quickly of course).

I've torn with all 4 but #4 was the least because at the pushing stage I was told to slow down and relax through the stretch and burn instead of being encouraged to push. When I was having C I ended up screaming NO (and another choice swear word ) at the midwife and OB who were telling me to push ROFL. I couldn't say anything else at the time.

[organicem]

I didn't tear with either of mine. I put it down to per massage. With my first I did have an internal graze but with second I had a water birth and no injury at all.
Good Luck. My advice...try everything...something is bound to work for you.

[Inanna]

I also want to add - I did perineal massage with my first & the tear was 2nd degree. The others I did nothing - and very little trauma with 1 and no tears with the other two...

I do use water immersion in labour & DD5 was born into the water...

[mbear]

MBear thanks to you I burnt my boobies by choking on tea!

...mmm sorry about that.....

I actually remember reminiscing about ( when trying NOT to push when all i did was WANT to push) the movie i saw 3 days before....Wolverine. I tried so hard to think of something that was not birth related,baby related, anything to do with me related...and whammo, i thought of Wolverine. It musta worked, coz i didnt tear.

I agree with Flowerchild...you will be great Bekz....it might be a little quicker being your third, so control, breathing and Wolverine.......