Inside: Learn how to prevent tearing during childbirth with these 9 tips!
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 usually happens in 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 deeper into the pelvic floor muscle or into the anal sphincter and while these are much more rare, they’re 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 most likely it’s not going to happen by chance. There are tips to follow to reduce your 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.
9 Tips To Prevent Tearing During Childbirth
1. Find a supportive healthcare provider
You want to find a provider who fully supports natural, unmedicated deliveries, because they’ll 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 on your back.
Midwives are a great option for a healthcare provider because they’re 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
2. Breathe the baby down
What often happens during labor is a healthcare provider will coach you on when to push instead of you 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.
This is where relaxation techniques during labor really come in handy!
3. Only push when you feel the urge
Again, many healthcare providers coach women on when, and how long they should push. While this can be helpful if you’ve had an epidural and you can’t feel your contractions, during an unmedicated natural labor, you’ll eventually feel that urge to push, (you won’t need anyone to tell you!)
By waiting to push until you feel that urge, you’re allowing your vaginal/perineal tissues to stretch slowly, (if they stretch too fast they can tear).
If you’re pushing for a long time, (as with coached pushing) you’re more likely to tear. You’ll likely have a faster pushing phase by waiting and listening to your body.
4. Support your perineum
This can be done by your healthcare provider when you’re pushing. They can use a warm, wet rag, and gently apply pressure to your perineum to support that area.
This helps the perineal tissues to not stretch too fast, (if they stretch too fast, you can tear).
5. Don’t push on your back
This position is not optimal for delivery, yet this is a common position for many women to give birth in.
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.
These are the best birthing positions to prevent tearing:
- Laying on your side
- Squatting and learning slightly forward
- On all fours
These are good positions to deliver in because they open up the pelvic area to give the 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.
6. Use warm oil
When you’re in the pushing stage, your healthcare provider can apply warm oil to your vaginal and perineal tissues to lubricate the area. This helps the baby “slide out” more easily, without much friction against the tissues, thus preventing tearing.
There’s a variety of oils you can choose from. My midwife told me to grab some from the grocery store so that’s what I did! (I had a bottle of olive oil sitting in my room with the rest of my birth supplies and I didn’t feel bad about tossing the rest of it after I gave birth because it wasn’t expensive!).
You can use any of these oils to prevent tearing during childbirth:
- Mineral oil
- Olive oil
- Unrefined coconut oil
7. 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). (source)
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.
8. When your baby crowns, you want to slow down
It can feel like an intense pain known as the ring of fire, when your baby crowns. You may even want to push harder and faster to get the head out and make that pain stop.
But instead of pushing harder and faster, you should slowly push or breathe the baby’s head out.
The purpose of pushing slowly at that point, is you’re allowing your tissues to stretch slowly. When you give them time to stretch, you’re less likely to tear.
9. Avoid medical interventions
Of course it’s every woman’s choice if they want interventions or not. However, interventions do come with risks.
The beauty of being educated about the childbirth experience, is that you can make these decisions by weighing the risks and benefits, and deciding what you’re comfortable with.
One medical intervention you may want to avoid is an epidural.
When you get an epidural, the whole lower half of your body is numb. While the idea of not feeling any pain from your contractions can seem like a great idea, there’s a downside.
With an epidural you can’t feel what’s happening so you won’t be in tune with your body. Being in tune helps you know when to push and what positions are most comfortable for you to push in. Plus you won’t be able to walk around to let gravity do its thing and bring your baby down.
Also you’re probably going to have to labor on your back and probably push on your back, (which again isn’t an optimal position for pushing).
Because you can’t feel your baby moving down, you can’t breathe your baby out. You’ll have to push when you’re told to push. You also can’t feel the ring of fire so you may end up pushing too hard at that point.
All of these can increase your likelihood of tearing.
Another intervention to avoid is an episiotomy.
An episiotomy is when the doctor makes an incision from your vagina into your perineum to make more room for the baby to come out.
A frequent reason healthcare professionals will say you need an episiotomy is because your baby is too big to come out without tearing, and that episiotomies are preferable over you possibly 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, but that’s 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’re told you’re going to have a big baby, doesn’t mean you’ll automatically tear, or that you automatically need an episiotomy.
The problem with this logic of episiotomies being preferable to tearing naturally, is 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, numbness in that area, urination and/or fecal incontinence.
If you do tear, the chances of it being as severe as an episiotomy incision, aren’t high.
And, even if you do get an episiotomy, you can still tear!
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.