A huge fear many pregnant women have, is tearing when they give birth. That’s a sensitive area and the thought of giving birth by itself is daunting let alone how things will feel if you tear. All pregnant woman want to prevent tearing during childbirth if they can help it!
First let’s talk about what tearing actually means. Tearing is usually the skin between your vagina and anus called the perineum. Those tears are very minimal and don’t require anything to heal on their own. Other tears can go into the pelvic floor muscle or into the anal sphincter and these are much more rare, but are more serious and can have lifelong effects.
Although it’s common, it is possible to prevent tearing during childbirth if that’s your goal! (I’ve had two vaginal deliveries without tearing!) But there are some tips to follow to reduce the chances of tearing. These are either tips I was given by my midwife during both of my pregnancies, or what she actually did during my deliveries to help me not tear.
How to prevent tearing during childbirth
If possible, have a health care provider who fully supports an unmedicated vaginal birth
They will be more likely to let you labor how you want without intervening. They won’t be as likely to push medical interventions on you, and will be more likely to allow you to deliver in a position other than your back. You might want to consider using a midwife as your healthcare provider because they are fully supportive of unmedicated natural births and are very likely to be knowledgeable on helping you prevent tearing.
Related: How To Have A Natural Birth
Breathe the baby down
What often happens during labor is a healthcare provider will coach you on when to push instead of pushing when you feel the urge. Unnecessary or unproductive pushing can lead to a longer pushing phase, and more stress and pressure on your perineum, which ultimately increases the chances of tearing. Instead of pushing right away, you can breathe your baby down during contractions. What this means is you’re letting your body actually do the work of bringing your baby down into the optimal birth position.
Don’t push until you feel your body pushing or you feel the urge to push
During an unmedicated natural labor, you’ll eventually feel that urge to push. By waiting until you feel that urge, you’re allowing your vaginal/perineal tissues to stretch slowly, (if they stretch too fast they can tear). You will also probably have a faster pushing phase by waiting and listening to your body.
Have someone supporting your perineum
This can be done with a warm, wet rag. The person can hold it to your perineum to support that area. It can help the tissues to not stretch too fast.
Don’t push on your back
This position is not optimal for delivery, yet this is a common position for women to give birth. Pushing and delivering on your back puts a lot of pressure on your perineum, which increases the risk of tearing. The way your body is positioned on your back makes it like your pushing uphill instead of using gravity to your benefit. This can prolong the pushing stage.
Giving birth on your side, squatting and leaning slightly forward, or on all fours are some good positions to deliver in because they open up the pelvic area or give baby more room, which allows the baby to move down.
Ultimately when you listen to your body and give birth in a position that you feel comfortable in, your chances for an optimal delivery increase.
Use a lot of warm oil on the perineum and vaginal tissues
Lubricating the area helps the baby “slide out” more easily and without much friction against the tissues. You can use some kind of mineral oil or olive oil.
Do squatting and Kegels together
There is A LOT of information that says pregnant women should do Kegel exercises all throughout their pregnancy. This is supposed to keep your pelvic floor muscles in good shape for delivery and during postpartum recovery.
However, there’s contrary advice that supports not doing Kegel exercises every second of the day because it can actually do more harm than good! This advice says that your pelvic floor works in conjunction with other muscles of your body. So if you aren’t strengthening those muscles too, your pelvic floor is not going to be supported. (A weak pelvic floor can contribute to tearing).
This was the advice I got from my midwife. She told me to squat three times a day. During those squats, you squeeze your pelvic floor muscles and release them 10 times. This strengthens the muscles that work with your pelvic floor, which helps prepare your pelvic floor muscles for labor and birth. This ultimately helps to prevent tearing. This website talks much more about this method of squatting and doing Kegels together.
When your baby crowns, you want to slow down
Yes it can be an intense pain known as the ring of fire, but you should slowly push or breathe the baby’s head out. The purpose of pushing slowly at that point, (even though that ring of fire can make you want to push fast to stop it!) is you’re allowing your tissues to stretch slowly. When you give them time to stretch, you’re less likely to tear.
Avoid medical interventions like an epidural or an episiotomy
With an epidural you can’t feel what’s happening so you won’t be able to be in tune with your body. Also you will likely have to labor on your back. Because you can’t feel your baby moving down, you can’t breathe your baby out. You will have to push when you are told to push. You can’t feel the ring of fire so you may end up pushing too hard at that point. All of which can increase your likelihood of tearing.
With an episiotomy, some doctors will say it’s necessary because it will be better for you than tearing on your own, (they’re assuming you’ll tear because they can’t know that for sure). I’ve had friends who were told they needed an episiotomy because their baby was too big to come out. That is not always the case. I’ve had some big babies…my first baby was 9 pounds 3 ounces and my second was 8 pounds 13 ounces and I didn’t tear with either of them. Just because you are told you are going to have a big baby, doesn’t mean you will automatically tear or that you automatically need an episiotomy.
You can also tear even if you did get the episiotomy.
Episiotomies can cause more damage than tears can. They can turn into third or fourth degree tears more easily, become infected more easily, and cause lifelong issues with sex, urination and/or fecal incontinence.
There’s no 100% guarantee you won’t tear during childbirth because your labor and delivery is your unique experience. HOWEVER, these tips can definitely help prevent tearing during childbirth if that’s your goal! Remember, doing something proactive to prevent tearing is better than doing nothing at all and just hoping you won’t tear.
*Please note I am not a medical professional, this is just my personal experience. If you have questions or concerns, you should discuss them with your healthcare provider.