Any ideas? How to avoid/help prevent 3rd degre tear this time?

[Henrietta]

Had a 3rd degre tear even after being given an episiotomy to try to prevent it happening last time. What can I do to minimise risk of it happening again...has anyone found doing anything diff helped?

My mw's advised me to rub almond oil (or similar gentle oil) on preineum regularly (after baths or showers for example).

Slowing down the second stage should help. (Easier said than done I know). Try not to push to hard. At that stage I always want the baby out, come what may, but in the long run it's worth one or two extra contractions if it'll mean less chance of tearing.

A very warm flannel pressed on perineum as baby crowns is a good idea. Try to breath, slow it down, visualise opening up - whatever may work for you.

If it's your sort of thing, you could practise visualising images of things gently opening (flowers etc) during pregnancy in a meditative state then try to recall these images (and the feelings they gave you) at birth time. It helps some people to say things about opening up or breathing the baby out.

There are also second stage positions which can help. Ask your mw about these.

Good luck.

I had a ceasarian. I was advised to do this by my consultant who was clear that if the area is put under stress and you tear along the same healed tear-it is unlikley to repair as well a second time. Probably not what you want to hear.

Everything Spidermama suggested worked for me on the visualisation side of things. I didn't use oil second time but didn't tear either time.

The main thing for me was not to rush or allow myself to be rushed by other people in the room, to take time and concentrate on the feelings down there as the DD's were on their way.

With DD1 I completely ignored the 'cheerleading' of the midwives to the point that they worried I was tiring, but I wasn't, I was just ignoring them and visualising what was happening.

With DD2 I felt her coming down the birth canal so quickly that I found myself wanting to lay on my side, with my legs closed! So I did and yet she was born in just two gentle pushes. There's a lot to say for instinct; I'm sure I would have torn if I hadn't instinctively got into a position which would slow her exit.

Another tip a friend gave to me which helped (although it does sound funny!) was to practicing slackening my jaw. Her words were 'slack jaw, slack vagina' which kind of gives it a humorous twist but with practice I found that indeed, the more relaxed my jaw was, the more relaxed I was down there!

i agree with taking your time even when being cheered on to push. I did so but firmly without overdoing it eventhough I knew doctor and mws were anxious to get baby out asap aided by ventouse. (my preeclampsia was not responding to the bp drugs and it was happening so fast it was too late for a section.) All I had was one small tear and lots of bruising.

now that I am thinking about it. I remember being told to hold my breath and push when baby was crowning. I did the opposite, I pushed and exhaled with the push. Even when I was instructed a second time to hold my breath and push, I ignored them and did the same. I had read the book 'Active Birth' which recommended this technique for second stage.

i also am terrified of another 3rd degree tear.my dd is now 16 months old and im due in july.i have only really recovered in the last 3-4 months after lots of physio etc.i know i will be offered an elective episiotomy but worried i could still tear like you did henrietta.will try the visualition techniques too.

HI there
I had a 3rd degree tear, my baby only few months old and still uncomfy there! They split through bum muscle and that just topped the whole thing! I cant offer you advise just wondered if it is more likely that you can tear again as most people say that it gets easier!
What is the norm recovery period? When does going to the loo become easer??? (sorry but not met anyone else who had this!)

I was told by a friend who didn't tear that wheatgerm was fab. I used it to massage twice a day from 36 wks and I didn't tear either. Also my 2nd stage was quick.

jenwa - think i've got the same thing. was fine, but recently started to become a bit of a pain in the derrier. doing my head in. so, you're not the only one! bring on the bran flakes...

Wonder if i'm ever going to feel normal again. If it's not one thing it's another.

An update for all you folks watching this.
I had a boy on the 2nd Jan and we're both ok.
Story as short as I can make it was ...
using tens at home decided to go to hosp expecting to be told to go home to find I was 8 cm dilated.
MW suggested using birthing pool for labour anyway as it was free. Contractions coming regularly. got into pool (took tens off) think this may have slowed down contractions but pain relief was about the same as tens but less annoying - breathed through contractions (also think it helped soften perenium).
When couldn't bear cont any more got out and put tens back on which helped although I had to build it up again.

MW said I was 10cm dilated but waiting for waters to break. They broke bit later but baby wasn't budging she checked and I'd gone back to 8cm! Cut a long story short I think we tried every position all fours,squat,sit up etc to get rid of 2 cm eventually did but baby's head wasn't rotating to come down. tried diff positions laying left lateral got contractions stepped up a bit and finally as head still wasn't budging much gave birth on the stool. It was the only position that I could "feel" baby's head to push out. Made good progress MW was aprehensive as more liable to tear on stool but as head was crowning we took it REALLY slow an panted the head out-started buttonholing but with a small cut with scissors and panting managed with only 1st degree tear. Very uncomfortable having head there for that long but well worth it...went home same day!!! And as I managed without gas & air or Pethadine this time I was "with it" and felt great.

Good luck to rest of you

Henrietta - congratulations! I'm really impressed. I feel quite stressed just reading about it, so i'm impressed you did it! So glad you were ok. Wow.