Is there anything that can be done to reduce risk of tearing?

[SeeyouontheothersideRay]

Hi all

I am 22 weeks pregnant at the moment and beginning to think about the birth (first one). The thing that scares me more than the pain is the prospect of really bad tearing leading to problems afterwards, esp with continence. Maybe I should be scared about the pain too but just trying not to think about that! I mentioned my worries to my midwife (who seems great) when I first met her. She was reassuring about it, said it is not always too bad, and I think she mentioned that you could make your skin stretchier and reduce risk of tearing/need for cutting by rubbing oil into your perineum - like just normal veg oil.

Do you think she was just being kind - i.e. suggesting something to make me worry less about it, that wouldn't actually make a lot of difference - or does anyone know if there is any truth in this?

Any other methods that you think would work to reduce tearing risk (other than not getting PG in the first place )?

I reckon the stretching with oil does make a difference - or at least it seemed to for me. Enlist your OH if you have that kind of relationship! I think I got my oil as a present and it was a perineum care thing from Mothercare but lots of places sell similar stuff and you could use a vegetable oil too. It's more about softening the area and getting used to the sensation. Two girls in my antenatal group also recommended the Epi-No (see www.epi-no.co.uk) but I didn't try that myself. Breathing also makes a really big difference and I really recommend pregnancy yoga (maybe Janet Balaskas style) for that. Good luck!

Thanks Klaska! Also, thanks for the link, gadget definitely looks worth investigating.

I also meant to say in the original post, I asked my midwife whether an epidural would increase the risk of tearing/needing an episiotomy, and she was fairly ambivalent about that, I suspect because she didn't want to put me off getting an epidural in the event I do need one for some reason. But it seems from reading these boards that an epidural does generally increase the risk?

Relaxation and not pushing to deliver before you get the urge, apparantly.
I've been learning some relaxation techniques for my 1st, due SOON!

Have a google of 'perineal massage'; I used sunflower oil I think from about 34 weeks (religiously with dd, less so with ds) and didn't tear or graze at all. I think research shows that perineal massage reduces the risk of tearing.

I think the jury's out a bit on the epidural issue. I know that anecdotally, there's much talk about not being able to feel when to push, cascade of interventions etc and this is definitely some women's experience. A midwife I know suggested that epidurals may indirectly lead to episiotomy, as women tend to request epidurals when they're getting tired, which in itself makes the baby harder to push out, so they'd have still needed an episiotomy even if they hadn't had an epidural iyswim.

hope that it all goes well.

I have heard that epidurals do increase risk of tearing/ cutting. I didn't realise though that you can slowly let epidurals wear off/ not get top ups as much/ as frequently to feel a bit more to control your muscles and breathing. I had a fantastic midwife and anaesthetist who talked me through all that. I did have an epidural as I ended up with syntocin and felt it was necessary with that (not dilating 2 days after waters had broken...) but no issues whatsoever afterwards - apart from a bit sore! I put it down to a combination of OH massaging perineum before and support during, pregnancy yoga and breathing practice and the amazing combination of supportive anaesthetist and midwife who walked and talked me through the transfer from epidural wearing off to gas and air.

Had my first six months ago, didn't tear. We did the perineal massage, and I also laboured a long time in water too, which I believe helped me not tear.

Good luck!

I was terrified of tearing and ended up with two tears and an episiotomy - took a few weeks to heal, but all in all it wasn't as bad as I thought it would
be. Good luck!

At the pushing stage, listen to your midwife. If she says don't push, don't push!

Thanks all - and best of luck pootros!