Any ways to minimise tearing??

[SquidgerInMyBelly]

Hello all!

I'm 35wks with my first - a few people have asked if I'm doing the perineal massage with olive oil - is it really worth doing? I figure tearing depends on the size of the baby and there's not much you can do to prevent it? At my last MW appt someone had just given birth next door in the pool - the MW said you don't feel tearing as much in the pool and basically sort of blamed the fact the girl had torn due to pushing during crowning - as opposed to letting the contraction do it. (I was thinking by that point you prob just want to get the baby out.)

Any advice? Many thanks.

xx

I have heard similar advice re not pushing too fast and letting you contraction do the work. This goes along with the hypnobirthing technique too.
Have also heard that water births can mean less tearing as you are more relaxed for baby to come out rather than forcing it out before your body is ready.

Please note: I am first timer so have no real experience...

When I asked my MW this question she helpfully told me not to worry about tearing, as they would probably cut me before that happened.

As it was I had an EMCS so not applicable anyway, although I suppose in a strange way she was right.

Listen to yiour midwife when she's down there and is telling you either to push or pant through the crowning bit. You will know when you are crowning and instinctively you will know to kind of slow down a bit, that's when the midwife will tell you to pant and breathe slowly to allow the head and sholders through without tearing.

I had an episitomy with ds, and with dd who was born last sept, I pushed her out in 5 mins with tiny weeny couple of tears which healed in about a week. Everything down there feels absolutely fine and no lasting damage. It's about listening to your body and your midwife

You can reduce the risk of tearing through perineal massage, water birth, being in a good position for pushing, not being coached to push hard and listening to the midwife when baby is crowning to let baby ease out, but in the end a lot of it is down to luck.

Different people just seem to have different tissue strength, and the position of the baby will make a big difference too.

Good luck!

i had a tear but not wear i did perinial massage with oil - worth a try> next time i shall be doing whole area with oil!

Thanks all - olive oil out tonight!
Will put all your tips on list for DH to remind me.

Much love x

In my experience, you can do everything 'right' and still tear badly. Maybe I was just very unlucky...

Hello - I did perineal massage and did not tear. It also gets the area used to the sensation of the pressure, which does feel odd at first. When crowning, I did not feel like pushing at all, it was all very quick and drama free - i had read the Hypnobirthing book and did all the relaxation techniques, I would really recommend the book etc - def worth a try. Very positive towards birth - I felt confident and relaxed. I was up and felt fine within 30 mins. Good luck

I would guess the best way to minimise tearing is to make sure you pant and don't push when baby's crowning. I told DH his main job during the birth was to get through to me to stop pushing and pant when the midwife said to! I ended up automatically stopping pushing anyway, as I got panicked as it felt like DS was stuck - I remember screaming "He's stuck, pull him out quick!" to which the midwife replied "He's just crowning, it's normal to feel like that, and there's nothing to grab hold of anyway!".

Fortunately my perineum was completely intact after, not even a graze. Unfortunately I had a 5cm long internal tear that went most of the way through.DS was only 6lb 3oz, although that was huge as he was 6 weeks early.

Basically, when they say pant, then pant. Otherwise just relax and try not to worry - what will be, will be, and even if you do tear the chances are you'll recover fine in a few weeks.

TMI alert!

With DS1 I tore badly, I had many internal stitches and have a cracking scar to show for it. I addressed this with DS2's birth and mentioned to the midwife in charge that day that I was concerned about a repeat performance. She was able to guide me through pushing a bit better and helped to ehem hold everything open down there as much as could be during the crowning and head delivery, I didn't even get a graze!

Titsalina Don't worry about TMI, can I just ask what do you mean by the midwife holding things open? Do you mean she sort of pre-stretched things? I'm currently pregnant with DC2, and due to severity of pre-existing spinal condition it's been recommended I avoid a CS if at all possible, so no chance of an elective. Because of last time I'd like to do anything that may help, so would be interested to know what the MW did to help you.

Now that I'm not 100% sure tbh, I was more concerned with the small person coming out! :)
I remember her telling me to stop pushing and she used her fingers to ease DS's head out gently as he crowned, she could have done more and me not been aware of it, but I recall her being very gentle and controlled at the head delivery to make sure there were no little hands coming out too! :)

I have found the best way to avoid tearing is to lay off the gas and air, order silence from the midwives and those around you and listen to your body. You may well find that you automatically pant rather than push and the baby will come out very slowly.

Also, in early labour use those first contractions to help the baby get into the best position possible. Perhaps lie on your front in the bath for a couple of hours.

I had v v bad 2nd degree tear with DD 3 years ago, i got an infection & it took weeks to heal. Am now expecting no 2 & really worried it could happen again. I think I'll be buying a bulk lot of olive oil!

I had a water birth and didn't tear, just a couple of small grazes. I think the water definitely helped to loosen things up a bit!

Ok this is bit of a long post. There was a book by Naomi Wolfe about childbirth that mentioned her meeting a midwife who referred olive oil to pregnant women and hardly ever had women tear so yes I think the massage thing can't hurt.

I had a wonderful water birth, felt very relaxed but I still had a massive PPH and an extremely bad tear, was stitched in surgery and suffered major blood loss but just got away with a transfusion - I think partly because they couldn't really measure how much blood I had lost because of the water.

I healed remarkably well. I did have issues with some initial incontinences and when I need to go to the loo I sometimes need to go fast but I'm all fine and it took months before I could every feel like I could go running for example.

I got to speak things through with a consultant and a group of students (who I got to see at hospital because I was in the High dependency unit) who was experienced but also said that there was not research out there as to reasons for tearing. Some people thought water births could mean some risk of increased tearing, and some people felt that Midwives may not be able to guide when to push in a water birth but then that seemed conjecture to this consultant and it could not really be proven.

I did have an extremely quick labour so I'm not sure if that had something to do with it? I also asked if it was to happen again - but the consultant didn't believe there was any reason in my case that it might or might not happen again.

The hospital I went to were brilliant I got to talk through the birth with someone 8 weeks afterwards which involved going through my notes seeing how I'd healed. To be honest because I had really great care although everything was explained to me and I knew it was all very serious I never ever felt worried. I do remember being white as a ghost for a few days though and the first time I looked in the mirror thinking by gosh why has all the colour drained from me! I also had a midwife who wouldn't let me have my first shower alone and asked my husband to take me - which was just as well as I kind of nearly collapsed. I do feel very incredibly lucky and blessed that things eventually healed up well and my baby was so well.

I've met women who have really beaten themselves up due to a traumatic labour - but I still see my birth as this kind of great positive wonderful experience - with a massive endorphin rush at the end?

Bear in mind that it's not (usually) the end of the world if you do tear either. I had a 3a tear with DD which has healed OK. Almost no pain afterwards.

Had an episiotomy with DS and that was really bloody sore for a couple of weeks.

Both were forceps births.

Tears are thought heal better than an episiotomy too.

I did perineal massage with oil before DD was born.

I hHad a very fast labour, and an idiot for a midwife who kept telling me to push even when I wasn't having a contraction. Not surprisingly, I told her where to go!

DD popped out like a champagne cork and I suffered a 3rd degree tear and massive haemorrhage. Even worse, I was then given an epidural, for them to take me to theatre to sew me back together, after giving birth with no pain relief, only a little gas and air.
Never had any debriefing from the hospital and the after care consisted of a doctor sticking his fingers up my bum and asking me to squeeze hard at my 6 week post birth check up!

I tried massage but gave up because I just couldn't reach & it was just too weird if DH did it!!

I didn't have a perineal tear, but I did have an internal 2nd degree one. I am not sure why, as I think my DD's head was delivered in a controlled manner. It must have been just luck & position.

I was laying down, despite not wanting to be really, so perhaps having to push her 'uphill' didn't help, and I did have a badly bruised coccyx, which was both a massive shock & very painful (more painful than the tear/stitches). For DC#2 I'm aiming for a mobile labour &/or a water birth!!

Danceswtihdragons [shpck] at your experience.

I just popped onto this thread because I am suffering from some pregnancy insomnia - jeez that must have been awful.

On my first pregnancy, we did the oil thing and ended with an emergency CS. It does help the flexibility of the skin but the size of the baby stays a major factor. As well as luck(((:

Try the massage, it can't hurt. I think I started it at around 34 weeks but had to give up around 38 weeks as I just couldn't reach! Nevertheless, I didn't tear, so I think it may have helped a little bit.
DD wasn't massive at 6lb 10oz either.
But most importantly: Do listen to your midwives when they explain the process, and pant when they tell you to pant! Brief your DP too so he can hold your hand and remind you.
Best of luck!

There is a homebirth on youtube that shows the attending midwife dousing the perineal area in olive oil just as baby crowned. Not sure if that is generally thought to be safe or not but it looked like a great birth.