Just a question about tearing

[2CheekyMonkeys]

thats a good question, i have thought that before too. in my situation i had epi and internal tears with first birth and then had an episiotomy with second (due to scar tissue from first) i dont think i would have torn second time because the pushing stage (and whole labour really) was so different. i WISH i hadnt have torn. i guess i see it as an achievement when i hear other people saying they didnt, i am like wow good on ya. but having said that i dont feel bad about myself or my 'labouring skills' that i did. when people talk to me about not tearing i think some people see it as just a good thing, one less pain they had to go through. some others who put in a lot of effort to avoid tearing during pregnancy would see it as an achievment i think.

[Olive]

i think it can be a combo of many things, i had epi with DD1 and a labial tear, with DD2 i started pushing on all fours but had to turn over because i was starting to tear internally as her head decended, i also torn along part of my old epi site and had another labial tear, i also swell quiet badly too, i was reviewed the next day by a OB and he said im just unlucky that i tear and that i probably have lots of stretch marks due to lack of stretchy skin, i has NO stretch marks so that baffled him i was just unlucky and i think no matter how i birth, i will tear

[meow]

I think there is much you can do to help prevent tearing so I do think that not tearing can have a lot to do with a more optimum birth. I tore last time and getting stitches was such a traumatising experience for me that I will be working with my midwife to prevent tearing this time.

I had a few factors that contributed to my tearing:
- no perineum preparation
- birthed on a birthing stool
- coached to push very hard, though reminded to stop during crowning it's a bit hard to slow down after all that pressure to push
- midwife supported my perineum during crowning
- baby was on a slight angle
- baby was over 4kgs
- dry birth on land

Obviously not all of those could have been prevented and not all are guaranteed contributors to tearing but I'm aware that tearing isn't just a 'chance' thing and I hope to be in a more optimum position next time and we'll see what happens.

[Fuzzywuzzy]

Interesting question Nik. I kinda liken it to getting stretch marks, in some people it's destined to happen (coming from someone who got tons of stretchmarks and also tore ) I think that there are lots of different factors involved and in my situation it was a case of crappy skin and the 10pd baby

[Arcadia]

For me it was a big fear, so I was really happy I didn't tear. I did lots of things to help:
-perenial massage from 36 weeks
-hot washer on perenium during pushing
-breathing the baby out at crowning
-a medium sized baby lol (she was born at 38 weeks)

I think the 'achievement' idea is really more relief and surprise/joy for those fearful of tearing.

It's silly to compare births though, because there are so many variables.

[Trillian]

Good question! I don't see it as an achievement that is to be gloated about, but for me, it is all about post-birth healing. Of course if you have a bad tear there is a risk of poor repair which may lead to further problems down the track. Some women tear so badly that they need surgical repair and that is something that you would never wish on anyone! Of my 4, I have had an epi, two 2nd deg tears and a small graze which required no stitches, so technically while I have never not-torn, I have experienced post birth without stitches and it was awesome!!!! When I was pg with my first, I read a book that said some Drs will do an epi as routine for first time Mums, so I asked my Dr about it and he said that he only ever did it if it needed to be done. He explained that he preferred women to tear so he didn't have to cut. Obviously he was happier still if women didn't tear at all. So while I did end up with an epi with my first birth because I was starting to tear straight down and my Dr wanted to avoid having a tear going down towards the rectum, I don't regret that, because as DH said at the time, there was 'no way known he was going to come out unless it was done' and he had spectacular head moulding at birth. I just think that being post birth without stitches is wonderful because when you have to do the first poo after giving birth you don't have to worry about popping a stitch ROFL! But after the first 3 births when I had stitches I was terrified of having to do a poo and took laxatives and painkillers before I needed to go so it didn't hurt as much plus I also had to support the area while I did it by holding a pad against my perenium - TMI possibly that is the reality of it.

So no, I don't think that by not tearing a woman has in some way had a better birth than one who did tear. You may have a woman tear that had a completely drug-free hands-off birth from start to finish and used every birth position known to mankind that would help reduce tearing, but a woman who didn't tear may have had given birth completely loaded on pain relief and flat on her back. It is all about perspective. If you think you had a great birth whether you tore or not is fantastic and no one can take that away from you simply because they didn't tear themselves.

[Mad Scientist]

Thank you all for your answers. I guess I just wanted to know whether it was a major thing, because as far as I'm concerned, tearing was one of the things I thought least about and it doesn't affect how I think about my births at all. It's just how different people talk about it too. And on the other hand, there are people who see tearing as some sort of badge too....hence the often asked question "How many stitches did you get?" as if the number of stitches indicates anything. I never knew how many stitches I had. All I know is that it took a really long time to stitch me up and it was actually worse than giving birth, headspace wise. If I had the choice I would tear over an episiotomy. The healing from the tear was a breeze compared to the episiotomy as I couldn't stand or walk properly for over a week after being cut.

Again, thanks so much for your insights. I'm so glad I got my question across without offending! It's so nice to get so many open and honest answers on, what I think, quite an interesting topic x

[Trillian]

Yeah, I don't understand that mindset about having a particular number of stitches either. I guess it is seen as a 'measure' as to how bad it was? And that is why I much preferred to tear as opposed to being cut as well. I didn't have a problem with walking, but with sitting and moving my left leg in a certain way was dreadful for about 2weeks until the stitches were gone. I do think it is a very individual thing though. For some women the measure of a great birth is not having stitches, for others it might be having a drug/intervention free birth and for others it might be something else entirely.

[Sagres]

That is a good question. I think as the others have said there a lots of different factors that all bear some weight on whether you tear or not. Some you can try to influence (birthing position, technique - for want of a better word - when crowning etc.), and some that are just luck of the draw (shape and position of the baby, shape and position of your 'equipment' etc.)

I think I am a bit with you, it is just something that happens sometimes and not others and you roll with what you are given. When I was doing prenatal aquarobics there was some discussion on preparation for labour to try and avoid tearing and our instructor who is a mother and spends a lot of time with pregnant women said much the same, if it happens it happens and you deal with it and then you get on with it. I mean tearing and the recovery is not fantastic but it is part and parcel of what I signed up for!

On not tearing being an achievement, you know I had never thought about it that way but now you mention it when I hear or read other peoples birth stories I do get a sense of either a) achievement OR b) just pretty darn happy. I guess sometimes it is hard to tell the difference (especially in the written word) between the former and the latter!