Preventing Perineal Tearing During Birth

Giving birth can be an exciting and life-changing experience, but it can also be nerve-wracking and intimidating, especially for first-time mothers. One of the biggest concerns for expectant mothers is the possibility of vaginal tearing during childbirth, which can be painful, require stitches, and take some time to heal. In this blog post, we will discuss some tips to help prevent vaginal tearing during childbirth.

The most common area of tearing is the perineum. The perineum is the area between the vagina and the anus, and it can stretch and tear as the baby's head passes through the birth canal. The severity of vaginal tearing can vary from a small, superficial tear to a more significant tear that affects the muscles and tissues around the vagina and anus. There are four degrees of vaginal tearing:

• First-degree tear: a superficial tear that affects only the skin of the perineum.
• Second-degree tear: a tear that extends through the skin and muscles of the perineum.
• Third-degree tear: a tear that extends through the skin, muscles, and the anal sphincter (the muscle that controls bowel movements).
• Fourth-degree tear: the most severe type of tear, which extends through the skin, muscles, anal sphincter, and the tissue that separates the anus from the vagina.

Most first and second-degree tears do not require stitches and heal on their own within a few weeks. Third and fourth-degree tears usually require stitches, and women may experience pain, discomfort, and difficulty with bowel movements and urination after the birth.

The risk of vaginal tearing can be reduced by practicing perineal massage during pregnancy, avoiding pushing too hard during labor, and having a skilled healthcare provider attend the birth. Here are a few practical tips to reduce your risk of tearing during birth.

Tip #1: Be mindful of your pushing.

It's essential to be aware of your contractions and to push calmly and guided by your provider. Avoid explosive pushes, as they can increase the risk of tearing. It's also important to take breaks between contractions to allow your body to adjust and stretch.

Tip #2: Keep your perineum warm.

Heat can help increase flexibility and dexterity, so placing a warm towel on your perineum during the second stage of labor can help prepare the muscles and skin for stretching. This can reduce the risk of tearing during delivery.

Tip #3: Deliver in an upright position.

While lying on your back with your legs up is a common birth position portrayed in the media, it's not always the best position for childbirth. It's essential to work with your provider to find a position that feels comfortable for you and allows gravity to work with you to help the baby move through the birth canal. Squatting or standing can be effective positions to reduce the risk of tearing.

It's important to note that every woman's body is different, and some may still experience tearing despite taking preventative measures. However, by being aware of your body and taking the necessary steps, you can reduce the risk of tearing, reduce the severity of tearing, and make your childbirth experience more comfortable and less traumatic.

It's also important to advocate for yourself and work with a provider who supports your wishes and needs. Many hospitals and birthing centers have options for different positions and pain management techniques to make the experience more comfortable. It's also essential to educate yourself on evidence-based birth practices to make informed decisions about your care.

In conclusion, vaginal tearing is a common concern for expectant mothers, but there are steps you can take to reduce the risk. By being mindful of your pushing, keeping your perineum warm, and delivering in an upright, non-flat position, you can increase your chances of having a smooth and comfortable childbirth experience. Remember to advocate for yourself and work with a provider who supports your wishes and needs, and educate yourself on evidence-based birth practices to make informed decisions about your care.

Anja Founder, Kathryn Cross, shared this vlog on preventing tearing that you may find helpful!