Exercises to avoid tearing/issues?

[squizita]

Hi all- I am coming up to the big 12 weeks. I have had 3 losses before this, thankfully am now on medication which has massively improved my prognosis (thanks NHS!). According to the calendars on these things, it's time to start thinking ahead (gulp!).

Due to my previous losses, I'm quite anxious about my body 'working' like a normal lady's when the day comes (my MWs have been fab and referred me to a nurse for support, again thanks NHS - I feel very lucky as I know it varies wildly town-to-town).
One thing I'm worried about is, if you read birth stories, 1st baby always seems to involve damage to mum (and yes, I know no one puts their bog-standard-average stories on websites, it's horrors or amazingly easy only). I understand that about 50% of first-time-mums tear/graze (or are offered an episiotomy) to some extent and you cannot guarantee anything at all ... but obviously would like to do what I can, if anything I find it reassuring to know whatever happens I've done "my bit" properly if that makes sense?

I am starting to do pelvic floor exercises every day.
Someone I know who has 'big babies' also mentioned an exercise where you use your thumb to 'stretch' your fanjo (tmi) to minimise tearing. Could anyone give me more information on this - when to start doing it, any links etc'?

Also, are there any other things I can do to get myself ready?

[ChicaMomma]

Yoga, swimming, squats, generally keeping fit.
Pereneal massage is the fanjo rubbing you are talking about- loads of threads on it here if you search- generally they say to start at 34 weeks.
Check out this bad boy: www.epi-no.co.uk

[Scotinoz]

I've got no idea about exercise to stop you tearing but Google perinnial massage...

I had a dozen stitches and I swear having the local anaesthetic injected was worse than delivering my baby! Stitches were fine though.

Pilates is great during pregnancy - you get classes tailored to pregnancy.

[squizita]

Thanks guys! :)

Scot I don't think my friend meant it stopped it happening, but she seemed convinced it helped so I'll give it a go. Thanks for the stitches reassurance too.

Chica thanks - got a while to go then. Glad I have a proper name for it!

[Bluesandgreen]

Not a lot of evidence on the epino but there is some so might be worth a go. Anecdotally, I used it as did a friend for our first babies and I had a slight graze that wasn't even classed as a grade 1 tear and she had no tears or grazes at all. It was also good as it did mean some practice at what the second stage feels like and I'm sure it helped me control that stage more easily. However, I also had an epidural which in itself reduces the risk of tears.

[squizita]

Blues thanks for that, glad you and your friend found it useful, will check out the website.

[InFrance2014]

If you have a partner, get them to do the perineal massage for you, don't be embarrassed about this! Buy some non-perfumed oil e.g. almond oil. It's a bit painful initially (mainly burning feeling) but gets much less so very quickly as you do it over time. Only take about 10 mins.

Weleda in France do a leaflet that you get given at ante-natal classes on how to do it, you can download it here, it's written in French (can use Google translate if you need to) but also has pictures: www.weleda.fr/fr/contacts/nos-publications/guide-du-massage-femmes-enceintes-et-allaitement/

It's improved my confidence to know I have genuinely stretched, and that even if I do end up with a bit of damage, I know (broadly!) what crowning will feel like, and won't be so scared when it comes to that stage on the day. It's about stretching you physically but also training you to recognise how to relax your pelvic area while feeling discomfort.

Good luck.

[Jess03]

Remember it'll be ok. You do what you can but if you do tear, even the bad ones heal and it'll be worth it. I wish it could've been avoided but I'd sign up for it all to get my lovely dd. well I have as having a dc2! good luck op!

[ChicaMomma]

Hi Bluesandgreen, that's pretty good anecdotal evidence from you and your friend! Also- for some reason i thought an epidural increased your risk of tearing, not decreased? Am i wrong? i definitely want to get an epidural!

Could you elaborate a little more about how it helped you deal with the second stage?

[squizita]

Exactly InFrance - it's that feeling of improved confidence, although I know a lot of it is luck!

[crispyporkbelly]

I did all of that but my baby was compound presentation (hand on head) so I tore like a mother!

[crispyporkbelly]

All is fine now after a year, can't even see it! So even of you do, it'll heal in time

[squizita]

Crispy Cripes! I hope you're recovered well.

I'm more aware than anyone of fate/luck etc' just changing everything. It's weird, I'm not sure how to explain it ... but it's almost as if because I am acutely aware things can (and with my anxiety/history I assume will) go differently/less pleasantly, it's really important for me to prepare as best I can. Even though it may not make a jot of difference! I suppose it stems from all the "what ifs" of multiple losses: it's not so much the outcome but that I can rule out the nagging doubt I "did something wrong".
I think it's a recurrent miscarrier thing. :(

[squizita]

Crossed posts Crispy - thanks for the update, v glad you're all better! :)

[Fishandjam]

I did PM religiously from week 32 onwards with DC1. Unfortunately it made bugger all difference in the end as I needed an episiotomy (ventouse/forceps birth). However, I healed up beautifully so maybe it had an impact on that, who knows.

I did PM again with DC2 and tore along the old episiotomy scar but it was nothing to write home about. Healed totally within a fortnight.

Like you, I found it reassuring to know that I had done something which might help, as it made me feel more in control of the whole experience (even if that feeling was illusory, if you see what I mean?)

[Fishandjam]

PS: my experience is anecdote not data, of course

[squizita]

Fish thanks, ever so helpful. And YES THAT'S IT! Phew I'm not a loony other people think it too That idea of taking control even if it's just psychological. :)

[Jess03]

That's what all the antenatal classes are for too, making you feel you are in control. It really will be ok, it's good to affirm that while preparing.

[notso]

I did in all my pregnancies and had a slight graze with DC1 and nothing with my other three despite DC2 and DC3 being 9lb plus and born with one arm up like superman.
I was offered an episiotomy with DC2 but refused as I felt confident I wouldn't need it and I was right.

[lockie1983]

Didn't do any massage as such ... Was saving that for maternity leave but baby decided to arrive on day 1 ...

Did do lots of squatting, yoga and generally being active.

Lucky for me, baby was in the right position and I just had a small graze. Whether it helped I don't know, but feeling like you've prepared well defo helped me during labour. Think it minimised the fear factor.

I had to have 2 stitches cos it was near my labia and they worried about it getting stuck or something, the anesthetic for the stitches was horrible and worse than any other bit.

[BuntyCollocks]

Never did any massage, had 2 small grazes and that was it. To be honest, if you ask for help to not tear, i.e. ask them to coach you through pushing, and then actually do what they tell you, I think that gives you a better chance of not tearing.

[PollyIndia]

I did it pretty religiously from 32 weeks - hated it. Also did pelvic floors and exercised right up to about 10 days overdue. Took 2 hours to push DS out and he has a big head but I had no tears.

Who knows if it was down to the perineal massage but if I ever had another baby, I'd do the same.

Agree with lockie, that feeling like I had prepared well made me look forward to labour and not feel scared. Also did hypnobirthing which helped.

[ThePequod]

I had a forceps delivery as baby was in distress, so had an episiotomy, BUT I did not tear in addition to the episiotomy. I like to think that this was down to the perineal massage I did from 34 weeks onwards! Who knows, but it makes me feel better!

Perhaps you could ask your midwife for a leaflet? In some NHS trusts there is information on PM in the maternity notes.

It's great that you are doing pelvic floor exercises as well - much easier to get into the habit now than to have to create a habit when it's really necessary. Good luck OP!

[PollyIndia]

And yes, agree with buntycollocks. The midwife was very precise with her instructions towards the end and I pushed him out very slowly once I managed to get him down the birth canal. That definitely helps with not tearing.

[Stockhausen]

Waterbirth!!!

10lb baby, no tearing or stitches. I was in the bath, then birthing pool. Convinced it softened everything up. Also took raspberry leaf capsules, but you'd need to check if ok for you.

I also had two losses before having DS& big gaps between conceptions, but have to say my pregnancy was textbook, as was my Labour, and I breastfed for 7 months too... So it seems it was just the getting pregnant & keeping hold of it until 12 weeks that my body was shite at!

[Cariad007]

I was terrified of tearing too so did perineal massage everyday but when it came down to it my baby had a large head so I did tear. However I do believe the massage helped, as the midwife said I have a short perineum and was fortunate not to get a third or fourth degree tear - just a second degree one. A week on from the birth and I'm already feeling much better and was told I should be all healed by the time the stitches dissolve in a couple of weeks.