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As birth is getting closer, I am starting t think about my last labour. I had a few small tears that needed stitches after birth. I actually felt myself tear during the head/ring of fire stage.
What sort of breathing Or methods did you use to stop yourself pushing during that crowning stage?
TIA :)
I just panted very softly both times while my girls crowned as instructed by my OB. I didn't tear with either, I had a mild graze with DD1 who was a vacuum delivery. I honestly think it's luck of the draw and maybe genetics but pausing and just panting softly is the technique I used.
Good luck!
We did lots of perineal massage for about 4 weeks before birth. I think it's recommended to massage scars to soften them and reduce the risk of retearing in the same place. I can't remember the breath I used- probably something I learnt in Calmbirth class.
Same as Taurean. I've birthed 4 times, 2 of those babies were 4kg, with no tears. My tip is to pant whilst crowning and listen to your OB.
Consider asking to be coached, get your birth support partner to tell your midwives/ob that you want to be coached through pushing. My first two I just did a big heave-ho to get it over with and had second degree tears, my third was my biggest by far, presented with her hand against her face, but I didn't tear at all, and I was coached through that delivery.
Some people prefer to be left alone to birth by instinct, and that is usually me, but I really appreciated having someone give me some clues on how to slow down a little and ease the baby out more than I would naturally.
This is exactly what happened to me with DD's birth. I just wanted it over and done with so did the big heave-ho!:
I am going to be having a student midwife with me so I might talk to her about it and getting her to coach me through and slow me down.
Nelle- so good to hear that with coaching and a hand beside her head, you still managed not to tear.
Thanks for all the advice ladies.
I think if you can slow down and ease through it- your amazing!!
if I have another I would like no cut or tear but Im a "out you go" kinda birther ;)
Im a 'get it out' type of birther and have had tears/grazes both times.
Love the suggestions for next time :)
I also just wanted DD1 out ASAP. DD2 was tiny, but came out with her hand behind her head. I actually did slow down and pant when they said and I had a couple of first degree tears, no stitches required.
I breathed DD1 out, my body pushed but I didn't make a conscious effort to. I asked for guidance, as in, being reminded to just breathe through certain parts. No tears or grazes, birthed on my hands and knees. Second stage was 1 hour and 40 minutes.
DD2 was fairly different when it came to pushing. I had overwhelming back pain that was only relieved about 10 minutes before she was born, so the urge to push was really dulled until that back pain was muted a bit. The urge to push was huge once that pain was gone, and I pushed hard lol. I did breathe through crowning and not push, but with extreme difficulty. I was thrown by how much faster she came compared to DD1 and asked my midwives a lot whether it was 'okay' to push etc. No tears or grazes, birthed on my knees in water. Second stage was 8 minutes.
I didn't do anything to specifically prepare during pregnancy for no tears. I inserted EPO but didn't massage it in. I think the key factor for me was good support, the two second stages were very different and both times my support people offered me suggestions appropriate to what was actually happening with me, which was awesome.
i birthed in water, i didn't push at all - held back completely, i moved around heaps during labour, ds was in a great position.
i don't know about coached pushing, if the coach doesn't read your body correctly, they are going to encourage pushing before time.
Both babies were 4+ kg.
I laboured in water both times.
First one I only pushed as my body urged, and only grazed. Second stage was 2 hr 27 minutes.
Second I asked for coaching, but if it was offered, I didn't even notice. Again I pushed as my body urged, ended up with 2nd degree tear and a graze, second stage was 10 minutes. But second time round it healed a lot faster, I just spent more time lying down afterwards. That made a big difference.
Both babies were 4+ kg.
I laboured in water both times.
First one I only pushed as my body urged, and only grazed. Second stage was 2 hr 27 minutes.
Second I asked for coaching, but if it was offered, I didn't even notice. Again I pushed as my body urged, ended up with 2nd degree tear and a graze, second stage was 10 minutes. But second time round it healed a lot faster, I just spent more time lying down afterwards. That made a big difference.
Once he began to crown and I felt the Ring of Fire (which I thought was some sick joke, but no. It exists!) I just panted and didn't push, even though I was told to. I had a slight graze.
I'll preface my response by saying I've torn (mild but did require stitches) in the same place with all three births, regardless of their size (2.9kg, 3.6kg and 4.5kg). However, I didn't feel it happen (in all 3 births) and didn't have any probs afterwards with pain/discomfort. Probably just lucky, I guess. I'd suggest perineal massage and then, during the final stages of labour/pushing, having a warm compress put on your perineum (by midwife). Probably my best advice though would be to do your best to listen to the midwives and try not to push when bub is crowning. Not necessarily the most comfortable of sensations as you probably recall, but it doesn't last long and gives your body a chance to adjust to the stretching.
at "ring of fire" stage ,pant, cough, blow gently and you will stretch up rather then "bust" through :)
I initially was going to have a waterbirth but after a few hours decided to get out of the tub. When i was pushing the midwife coached me when to breath instead of push. My baby ended up having severe shoulder dystocia and needed to get out fast. But even though i had a midwifes hand up there AND he was 5730g i only had a small tear on a previous scar that didn't need stitches. I really think it was spending time in the water because you'd really think i'd be torn up with all that but i wasn't.
I did not tear with any of my 5 births, my sister once said I have a "Box built for birthing" LOL.. BUT on a serious note, I did Perennial massage with all of them. I also recall the pushing stage being more a breathing them out stage. I don't feel like I "pushed" anyone out. More I just let my body do its thing. I did have grazing with my 1st & 5th, but nothing that was an issue 24 hours later. I also had 2 posterior births & 2 over 4kgs. But they all had big heads all the same!
I haven't torn with any of my babies (just minor grazes which stung a little). Some of that is genetics, I think, but there's definitely something to be said for panting and breathing through the pushing, as much as you can as the head crowns. Talk to whoever is doing your delivery about wanting to avoid tearing and ask them to help you. (remind you to "blow out the candle") With my first, the nurses placed warm cloths on my perineum as the baby crowned, which felt great, helped me to direct my pushing, and I think helped me not to tear. I also don't get the overwhelming urge to push like some women do. I am usually able to breathe/pant when they tell me to. Some women just can't help pushing with all their might!
Waterbirth also has a much lower tear rate, (as well as being GREAT for pain relief!) so if you can, labour and/or deliver in water.
Both my births I haven't had any tearing. I am another just get it out of me birther - my first was a 15 min 2nd stage vontouse delivery with a graze & my second was 3 mins no tearing.
Both times I was coached by both my Ob & the midwife on breathing and pushing but like someone else mention I think some of it is genetic too. There was a thread a while ago on the link of stretch marks & tearing.
I plan to breath the baby out this time to prevent the massive tearing I had last time but it was pretty much impossible to do last time my body was evacuating that baby and there was nothing I could do to stop it
A question for midwives/doulas and for those who say their body just pushed the baby out too quick - If this happened the first time, Can a change in position of Mum slow this down at the end? Are there better positions to be in to slow things down?
I know from my preg yoga class that downward dog is a good position to slow things down in labour, however I'm not sure that would be possible at the point of crowning ;)
I had to labour on my back due to monitoring etc. I just tried my best to breath her out, I had previously listened to calmbirth cd over and over so counted my breaths. My midwife was very specific about when to let my body push and when to pant or blow out. She also applied pressure when bub was crowning.
I ended up with 3 stitches all internal and to the side not to perineum. So still a little tearing but nothing too bad.
:)
I'm not a midwife or a doula, sorry, but I'll put in my two cents! :):
I think that squatting is known to be a fast delivery/high tearing kind of position. Great for moving baby down if he/she is stuck, and great for fast progress, but not ideal for the actual delivery. I *think* that semi-reclining and all-fours positions are a little easier on the perineum. And, as I said before, waterbirth is known for low tear rates. The warm water seems to help the perineum relax and stretch. Even laboring in water should help, if you aren't able to deliver in water.
I think a lot of it has to do with positioning, both of the mother and baby. But also relaxing as much as possible and breathing baby out once they reach crowning as has already been mentioned.
In my experience my first birth has been the only one I've torn, technically was only a graze and only needed 2 stitches. But i don't believe I would have had any problem if I actually HADN'T listened to the mw lol.. not what she actually said to me but ds was crowning and I heard the trainee mw say would he be born soon, to which mw said 'oh no definitely not 45mins at least to go'... To which I decided 'hell no! I'm getting him outta here in the next push that'll show you!' Yup in hindsight pretty silly/funny but still. I was also on my back this birth.
Dd1 was tiny at 6wks early so I certainly tried to slow things and breath her out to make her entrance a little easier on her.
Dd2 (my biggest baby so far) was in a HUGE rush to come out! I did not push voluntarily with her but I did lay on my side to slow things down and actually literally held her head in place for a contraction and delivery to allow at least some time for stretching because i was determined.not to tear again... I didn't even get a graze at all and really think those techniques prevented that.
Ds2 was a truely wonderful birth. I birthed on my knees leaning on the bed, which was good for opening up the pelvis fully while also keeping pressure off the perineum. If I hadn't have had a newborn attached to my boob straight after I wouldn't have guessed I'd just given birth everything 'down there' felt completely normal.
ETA- cricket yes all fours is good but nope reclining is not, its actually pretty much hands down the worst position to birth in for lots of reasons (but very convenient for Dr/mw viewing), it compresses the pelvis making babies decent more awkward and puts pressure on perineum also. Having said that my first two were in this position and it is doable just if its possible to be another way its almost always going to be better ;)
In my research for this last birth i read that if you have really fast labours/second stage that a good way to slow it up is to use gravity...in reverse! get your butt in the air baby :) one midwife asked her birthing lady to get on all fours but leaning down on her elbows with her bum in the air. she was still able to breath baby out and as crowning happened they changed position to her on her knees in a slight recline (i think that was how it panned out...).:
For me, i avoided tearing by letting my body do all the work. i wouldnt even say i 'breathed' her out as this might imply that the breathing was what got her out, but in reality i just took a bodily step back and using my breath to slow my adrenaline release and to get through the waves of pressure pushing bubs down. it is really cool letting go like that and feeling your body and baby working together 100% in awesome harmony.
Yep exactly what cassius said... She's just better at wording it than me I think! Lol
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Funny - all my babies have been born with me semi-reclining. It's the one I've chosen naturally, and moving out of it felt terrible! You can pull your knees up easily and open the pelvis more, although the tailbone will still be somewhat compressed. The old "classic" birth position - lithotomy, with you flat on your back and your legs up in the stirrups was a really lousy one.
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Funny - all my babies have been born with me semi-reclining. It's the one I've chosen naturally, and moving out of it felt terrible! You can pull your knees up easily and open the pelvis more, although the tailbone will still be somewhat compressed. The old "classic" birth position - lithotomy, with you flat on your back and your legs up in the stirrups was a really lousy one.