For those who didn't tear - what position did you birth in?

[Willow]

I was on my back both times and didn't tear.

[Fleur]

With DD1 I was made to lie on back to slow delivery, and I grazed, needed a few stitches, she was 8lb12.

DS1 I was on all fours leaning into a beanbag, he was 9lb13, 5 min 2nd stage and no stitches. I put it down to him being a 2nd baby?... I just figured it was better after the first one?

TBH I don't really remember whether I slowed pushing at the crowning stage or what I did at all for that matter, I just remember his shoulders got a bit stuck... now I wish I could remember!

[Visitor7]

I was on my back both times and didn't tear.

Yep, me too. Both times I was on my back.

[Rachel]

I was squatting...legs spread as wide as possible...i just went with the contractions...I was waiting to be told to not push when DD was crowing but I wasn't so i just went with what my body was saying...no tears. Fingers crossed I can do it again like that in 5 weeks give or take!

[Julie Doula]

All three times I was on my knees. The first and third time I did not tear. Little tear with the second birth, due to it being pretty fast and I forgot to 'back pedal' (she was born in a hurry in a shopping mall.)

Some women just have lovely stretchy vaginas. All vaginas are designed to stretch, are tough, strong, stretchy and tensile, and heal beautifully from minor tears. Yay, the vagina!

Here's my thoughts on supporting optimal wellbeing for the birthing vagina and the lovely perineum:

* Grab a copy of My Pelvic Flaw and learn all about really good pelvic floor exercises.

* Consider perineal massage and gentle vaginal exploration. I don't believe you need to stretch or condition your tissues. They're naturally designed to stretch! But, gentle massage and exploration might be good for a mumma to get in touch with her body and *discover* just how awesome, strong and stretchy it is. That was my experience, anyway.

* Use a birth pool & give birth in water! The gold star standard for perineal care.

* Listen to your body and ban 'Directed Pushing'.

* Gravity, uterine contractions, the foetal ejection reflex, and volitional pushing are 4 different forces that are involved in the expulsion of the baby. You rarely need all 4 forces happening at once! In an uncoached, un-coerced birth, the FER is really strong. When the mother just goes with it, she rarely needs to push and strain.

* Wait until the urge to push is absolutely overwhelming, Like, don't start pushing because you've been *told* you're fully. Don't start pushing as soon as you first start feeling pushy. Welcome and celebrate when you first start feeling that unmistakeable pushy feeling. But if you can, keep breathing through the pushiness until it's just so overwhelming that you can't hold off any longer. Blow out forcefully if you have to. I watched one first timer mama do this in a strong rhythm - puff-puff BLOW! Puff-puff-BLOW! The rhythm really helped her stay in control and resist that urge. Then - just go with it! Mischief can be caused by *telling* a woman to 'push', or if you're an impatient mama and you give into that litle demon whispering in your ear that if you push heaps now you can get this over. Tell that imp to shut up and go away. Heaving and shoving and pushing too hard too soon could be counterproductive and set you back. Keep breathing ... be patient ... trust your body ... kinda boycott the pushing thing for a while ... eventually it will be so full on, it will be undeniably the real thing. Wait till you're "11 cm dilated" before starting to push.

* Get gravity on your side and make sure you have the freedom, and the motivation, to follow what your body is compelling you to do. Some women really do like to push on their backs or on their sides. But make sure you're not doing that because of the subconscious influence of The Bed, the staff, or the media!

* Check out this study that associated the kneeling position with less perineal damage. Worth taking into consideration.

* Consider using only one or two of the 4 forces. Such as, gravity and the FER, but not pushing. Or, pushing gently between contractions rather than during contractions. That's when you're trying to ease bub's head out really gently. (I nailed this with birth #3). Or, eliminate the gravity factor if it's coming too fast, by kneeling into a knee-chest possie, or lying down in the birth pool or on your side, for example. You may not need to use all the 4 forces all at once, especially if the birth is progressing well and the baby's head is advancing. Some women find kneeling, then dropping their head down into a knee chest, helpful to slow down a fast second stage to a manageable sped.

* When you can feel that burning ring of fire, you're as good as done. That burning is your signal to BACK-PEDAL. In most cases, strenuous pushing efforts are no longer needed. It's time to stop pushing, and just b-r-e-a-t-h-e your baby out. Don't be tempted to just rocket that wee bub across the room. It's better to gently ease your bub out over the length of a couple of contractions than give into the urge to 'just get it out' (through gritted teeth)!

* Watch the shoulders! Congrats, you just birthed the head - awesome! Now, gently does it with the shoulders. Unless the shoulders are sticky and there are concerns about possible dytocia, there's NO RUSH! Sometimes large heads are born with no tear, then little shoulders cause a rip because of too much rush.

*Reach down and feel inside your vagina, and touch your baby's head. You can feel just how close your baby is. As the head starts to emerge, a little more each contraction, reach down and feel whenever you want to, if it helps you connect with how your body is stretching & how you're progressing. This tactile approach helps some women know 'where they're at'. Other women would rather shut their eyes and do it all by feel. But hey, your fingers belong there more than anyone else's fingers.

* Watch that second birth! If you had a long arduous first time labour, you might not realise how much quicker your next birth could be - especially if bub #2 comes along within about 3 yrs of the first.

[Arcadia]

Wow, there have been some great posts...

I was on my knees, leaning into DH who was sitting.

My midwife massaged and stretched the opening when I was in 2nd stage, and held the head back a little bit. I was a bit tentative to begin with when pushing, but then really started to get the hang of it, and I think I could have done some damage if my midwife hadn't helped me so much.

Water is supposed to be amazing, but bare in mind, the midwives can't see what's happening so well - so if you want that guidance on when to pant etc, I would go landwise.

Good luck with it. Tearing was my biggest fear in labour, but I only grazed (because darling DD had her hands up in her mouth when she was born!!)

[krysalyss]

I was on my back.

[CathyS]

Thank you so much! Esp Julie Doula! I hope it is helping other women on here as well thinking of positions to birth in.

I actually remember when my son's head was being born and I was taking my time (ring of fire) and she was like "Come on, let's get this baby out"...I did feel a little rushed now that I think of it.

[Glamourcide]

I didn't tear with DD (4-hr induced labour, VERY intense for a naive first-timer!) and I was sort of half-lying on my back, half-sitting, and using my arms to push my backside off the bed while I was pushing to make sure she was clear of the bed lol... I was worried that she would come out and I'd be sitting on her, kwim lol??

Umm, my biggest tip to prevent tearing would definitely be to take it slow and try to avoid drugs - I put my 'success' in not tearing down to those two things. I used gas at the start, and had pethidine (which did NOTHING to stop the pain, just made me really tired and no way am I going there again if I can help it) and I believe if I'd given in and had an epidural I would have torn because I couldn't feel that 'ring of fire' nad would have just pushed when told to by the midwives. It hurt like the bejeesus as DD was crowning but it let me know my limit, and to hold off until it had eased a little and I had stretched some more, so when I pushed again, there was room to move rather than just squeezing her through that awful burning feeling and tearing.
Don't let anybody rush you - I had one heinous midwife whispering in my ear threats of an episiotomy because I was 'taking too long' - I 'accidentally' kicked her to get her out of my face and went at my own pace. The thing that annoyed me was that I had laboured perfectly fine the whole time, and was only 'slowing down' to give myself that chance to stretch - the monitoring was showing that DD's heartrate was completely fine, she was not in any distress at all, I just needed to slow things down a little to NOT give myself some serious damage. Your body will let you know what's good for you - don't let a stranger tell you they know better.

I'm aiming for a more 'active' labour this time around, hoping to labour spontaneously so that I can move around rather than being confined to the bed hooked up to drips and monitors, and I'd like to try a more gravity-based position to birth in - probably on all fours as I find this quite comfortable when DTD and I imagine it would be a lot less draining on me physically to not be flat on my back or half-sitting, and holding myself up the way I did with DD. But yeah, I'm definitely going to avoid an epidural again so that I can 'feel' where I'm at and stop pushing before my perineum is ready, I'm convinced that was what did the job for me with DD - she had quite a big head for her size (and was 8lb 1oz born, so not tiny by any means).

[Julie Doula]

Gothmum, you did good to be so assertive in a situation like that when most women would feel quite vulnerable. Sounds like there was no need whatsoever for you to be hurried up - quite the opposite! You did well to (ahem) kick away the unhelpful advice, stick to your guns and go at your own pace. Sheesh if a 4 hour primip labour is "taking too long" what hope is there??

I agree with you that being unmedicated (ideally) helps you manage the pain better, keep your freedom of movement and use of gravity, and avoid tearing because you can feel what's going on and 'listen' to your body.

[Inertia]

ITA with the idea that being unmedicated helps with tearing. If it hurt too much then like with everything else, you stop what you are doing. I have always had the philosophy that all pain is good. I mean, if i stuck my hand on a burning hotplate without realising, the pain would make me notice and I'd remove it again quick. If it were not for the pain, I'd have a cooked hand, iykwim. So I am not really one to go for numbing pain because it tells me my limits. Such as if my ankle hurts to put weigtht on it, then dont cover the pain.. just dont put weight on it!

Just a different perspective on pain and Pain relief for people.

Unless its an ear infection or tooth ache, there are no limits to be breached with those buggers. Just hand me the doxylamine and back away slowly!

[Julie Doula]

Just hand me the doxylamine and back away slowly!

Love your username, Inertia. Sounds like an Asterix/Obelix name!

[Inertia]

Love your username, Inertia. Sounds like an Asterix/Obelix name!

It reminds me that no matter how much I want to stop, life insists on pushing me along for the ride.

[BekZ]

Great thread ladies. Very interesting reading.

I tore both times and I am hoping not to tear this time

[TwinsMummy]

I layed in my back and didnt tear but i massaged my perinium a week before birth... helped relax so i didnt tear.

[Gabi]

I delivered on my side and I didn't tear.

I put it down to the speed of delivery (ie slowly and controlled) and a good pelvic floor.

[CathyS]

Hey everyone!

I just wanted to say that I gave birth on May 31 to my little girl leaning on a bean bag over the bed (on my knees/all fours) and I DID NOT TEAR!!! Thank you so much for everyone's input. It helped me make a decision how I wanted to give birth! I don't know if it was the position, me 'back pedalling' once the head crowned...I did it slowly and when my body was ready), I had a fantastic midwife, and I used an epi-no. So..maybe all those things combined. I had a GREAT birth!! (we even got to film it!) The contractions were VERY intense (painful!!) but I somehow managed to do it without drugs (oh man...this labour was way more painful than my first with my son). I couldn't have done it without leaning on my dp (I was standing up the last half hour or so before I got on the bed, before that I was on a birthing ball). The pushing out part is the best though! She was 8lb 4oz, 52.5cm long, 36cm head circumference.

[Julie Doula]

Awesome news, Cathy! Congratulations. Sounds like it was a really satisfying birth for you. Blessings for your babymoon!