The vagina and perineum are designed to stretch during birth and some minor tearing during birth is relatively common especially for a first-time mum.  There are different types of tearing with the most common being either first or second degree tearing. These types of tearing tend to heal within 1 to 3 weeks after birth.

More severe tearing is relatively rare with an estimated 1% chance of it occurring (1 out of 100 births). It’s even rarer for severe tearing to lead to long lasting damage. The main factors which raise the odds of more severe tearing include baby being in a non-favourable position, having a larger baby, having a higher BMI, being over 35 and having medical interventions with use instruments such as forceps.

With our open and flexible positive birth mindset, we aim to stake the odds in favour of preventing unnecessary tearing or significantly reduce the risks. It’s useful to know that when oxytocin and endorphins are high in the bloodstream many women don’t even register tearing until a midwife tells them after the birth.

We’ll be talking more about the mindset for the early weeks with baby which includes self-care and supporting physical recovery.

Below are some of the ways to help yourself prevent unnecessary tearing during birth.

 

  • Birth positions –

Using gravity positions is one of the best ways to avoid unnecessary pressure. This includes all fours, lying on your left side, half kneeling or kneeling with arms on the bed or a chair.

Squatting can add too much pressure to the perineum for most women. In some cultures, in the world, squatting is a part of daily life so might be a positive position for birth as the pelvis will be properly aligned. For those of us that don’t use squatting as a daily way of sitting, it’s very difficult to hold for long and can create a huge amount of tension in the legs. 

Lying on the back or on the back position with legs up in stirrups have the highest rates of tearing.

 

 

  • Understanding the second stage and trusting the body

Avoiding ‘purple pushing’ and coached pushing will greatly reduce the possibility of tearing.

Purple pushing is what you see on the TV dramas where the woman has clenched teeth, is squeezing everything and going red in the face. This type of tension and aggressive pushing is most likely to put extra force and pressure on the perineum.

Hypnobirthing tools will help you and we will be exploring this more fully. The key really is to learn to tune into what your body needs in the moment and work with it rather than holding your breath and exerting too much stress when helping your baby out.

 

  • Supporting the perineum

Applying a warm compress or flannel to the perineum as baby is being born to help relax the area, keep it warm and support it. A midwife can help with this.

 

  • Perineal Massage

There are mixed views on perineal massage. My advice is to do it from 34 weeks if you are comfortable doing it. Some say it helps prepare the perineum to stretch more easily in labour. Others suggest that it’s more about the psychological benefits that a woman gains from connecting with this part of her body regularly, getting use to the stretching sensations and using it as a time to practice her breathing/visualisations. Either way, most midwives now recommend it.

The recommendation is to do perineal massage 2-3x a week from around 34 weeks of pregnancy. If it’s a practice that makes someone cringe, tense up or feel in any way negative I always discourage this practice as our aim is to create positive associations and helpful inner narratives for birth.

Ask for the separate sheet for more guidance

 

  • Think about having a water birth as an option

Water has been proven to help a birthing mum stay fully relaxed in her muscles and maintain forward leaning positions.  The warm water also supports a mum’s weight helping to reduce any extra pressure.

 

 

  • Understand interventions & different choices

Having an epidural or another intervention increases the likelihood of tearing. Natural tearing heals far more quickly and better than an episiotomy or instrument created tearing.

Sometimes interventions can be the most positive choice in the moment so it’s useful to understand what choices you have including the pros and cons for each.

We will be discussing this further and how to create a balanced, informed view for what’s right for you.

 

 

  • Actively encouraging baby into an optimal birth position

Practicing good posture and regular gentle exercises to align the pelvis help greatly to encourage baby into a positive birth position. Good alignment during birth not only helps to make baby’s journey easier but reduces the need for medical intervention.  See initial notes you received on sign up and the website – spinningbabies.com for more info on this.

 

  • Trust the body’s ability to heal

This area of a woman’s body heals far more quickly than other areas of skin or tissue and most minor tears heal without any longer-term effects in 1 to 3 weeks after birth.

Even 3rd degree or 4th degree tearing will heal with the right care and given enough time.  Longer term consequences from more severe tearing are very rare.

The body has an amazing ability to heal itself if the right care is taken. There is a huge amount of research into the power of the mind to support and help speed up recovery times and healing.