Tearing... did you know ?

[pupuce]

Right as I see so many threads where you guys mention tearing... can I share with you some info which might help?
First of all a major (thousands of women) study has proved that if you do perineal massage (if it is your 1st vaginal delivery) you reduce your risk of tearing ! The stats are not as impressive with 2nd birth BUT there are less tears in 2nd births generally anyway (I know many women who did not tear for their 2nd baby whilst they did for their 1st - usually because the 2nd stage is better).

2. You do tear MORE if you are lying down (in bed with monitoring and drugs pumping : the synto drip or the epidural)!

3. Risks of 3rd and 4th degree tear are higher in women who are given an episiotomy. There is a simple "desk" test you can do... take a piece of paper (or cloth for that matter)... wiggle it violently in the aim to break it... it probably won't break (unless you are very brutal) ... now cut it a bit and wiggle it again.. it will tear! It's basic ! Meaning women given episios often tear as well!

4. Coached pushing increases the risk of tears

5. Women who listen to their body (and I sometimes have to remind them of this or at least the MW should!) will birth GENTLY and not tear!

More info here and here

Pant, its the best way to stop yourself pushing after the head crowns

Also the line, stop pushing and pant fast now or you will tear, made me stop suddenly

i guess i must be the acception to the rule! i gave birth on all 4's in a very controlled manner and had a 2nd degree tear invloving lots of stitching, but then my tiny 6lb 15oz baby came out doing a superman impression!

2nd time - again on all 4's, i think she came out a bit quite for anything to stretch! 2nd degree tear again

Does it make any difference how fast the last stage goes? Both of mine were uncoached - pretty much left to my own devices for both, but the pushing stage was fast... these babies semm to poddle through the rest of labour then decided "That's enough, I'm bored now, I'm coming out NOW!".

I had similar tears both times - first was left to heal naturally, second time they insisted on stitches due to me healing very strangely last time.

I was just wondering if the babies had come out more calmly if maybe there are less tears?

just want to add midwives on both occasions very fanstatic - the one to one scheme is amazing

That sounds about right to me!
With dd1 i was pushing ,lay on my back and i tore,hence months of walking like a cowboy.
With dd2 the birth was so rapid i ended up giving birth on my bathroom floor with only dp present, but my body just did all the work and i pushed dd out with all my might and guess what ,no tears or pain or anything!

not sure about the speed thing? both of my labours were 45 minutes long, pretty quick...

i tore with dd but that was on my back, no coached pushing, except them telling me i was doing it wrong (not sure how) and telling me to push longer but my contractions kept stopping (only lasted about 20 seconds each at the end v. strange) still tore tho, but dd had hand next to her face and elbow out at a funny angle so that probably didnt help, next time i will try to relax and just do what my body says, im sure it knows best!

With hindsight, I was pushing when I shouldn't have been - but as it was my first, you trust the midwife. I can't remember ever having the overwhelming urge to push.

Suspect that I had been in trnasition when midwide started encouraging me to push.

No wonder then that I ended up exhausted - I can remember going to sleep during contractions (just dirfting off slightly) - and so I ended up having mid cavity forceps.

Can remember asking if they couldn't use a ventouse, but the daid that ds was still too high.

I was on a bed, but wasn't on my back. Was doing my best to stay as upright as possible and was sort of leaning over the birthing ball.

Had been induced eventually as waters had gone over 24 hours before, so was also being monitored. Midwife wouldn't let me stay standing with dh supporting me as "we hadn't practiced it"

Did have an episiotomy becasue they were going to do the forecps - and I did tear as well.

I'm the exception to the rule I'm afraid.

I gave birth at home four times, no drugs, listening to my body, on all fours, standing and squatting but I tore badly every time.

I think head size has a fair bit to do with it too. Also, if they will come down with their hand up ...

(Crosses legs hard with the memory.)

spidermama, same about hand up, what lovely darling children we have!

Had episiotomy with ds1 and he was 6lbs 6oz so not a big baby.
Had 2 small tears but no stitching necessary with ds2 6lbs 13oz.
DD was 9lbs 14oz and had a 2nd degree tear(could have been worse).Her head had been delivered and i tore when her shoulders were delivered.I remember mw really yanking her out and my birthing partners said it looked really brutal.Don't know if that had anything to do with the tear or not but hoping for a homebirth in a pool this time,and hope to have a more controlled delivery and less coaching.

Ds was quite big (8lb 15) and also had a very big head (91st centile).

I have been told that the next one would be easier - but it doesn't look like there will be a next time

Aw pretty. Sorry.

Those of you who had a birth in all 4s and did it slowly - did you do perrineal massage ?

yes with almond/jojoba oil in my case
I was more upright than all fours to be fair

Do midwives ever not do coached pushing????

Ds1 - induced, delivered lying on back, epidural, 2nd degree tear, needed quite a few stitches. Can't remember what mw was like about when to push etc.

Dd - home delivery, delivered kneeling against bed, basically 'coughed' her out - mw got me to cough instead of push so pushes were very small. Previous tear retore (still 2nd degree tear) but no stitches required

Ds2 - again home delivery, same coughing technique, (and same mw) but delivered standing up, same tear as with dd but again no stitches.

So could have been worse - think the mw saved me from worse tearing by really controlling the pushing etc. And my babies were BIG - between 9lb12 and 10lb1.5oz

neither of my midwives coached me during labour, except to say go with what you body is telling you, you know when to push and told to pant once head was out.

pupuce - no massaging here - always meant to but dd1 was 3 weeks earlier and i never got round to it!

midwife only had to catch baby here too

did tear though, maybe coz ds appeared with hand on head

i always assumed that if i'd communicated better with midwife and let her "coach" the pushing stage I'd not have torn

very positive experience on the whole...but still terrified about doing it again in September

Message withdrawn

I probably ought to point out, for the sake of correctness that first time round i had an episiotomy to facilitate a ventouse delivery. I had an epidural and didnt know when i was contracting or "where" i was pushing. The mw had to tell me or i would look at the monitor. I had alot stitches and when i went back for my 6 week check only then was i told that i had a tear that had gone all the way up.

Second time round i didnt have an epidural, just gas and air so i felt everything. Which was good for me because i didnt want to have the same happen as before.

I was coached again with this delivery, but, i have to say, that i came away the second time with a "graze". Even though I stopped contracting halfway through DS's head coming out.

I am amazed about what you have said about coached pushing, after I spent 4 hours being coached to push...it was a horrific and exhausting experience. I was even being coached to push when my contractions stopped after about 3 and a half hours.