Water birth - help or hinder tearing?

[lexib]

I've been told both that water helps prevent and causes tearing now, by different medical professionals.

Can anyone share their experiences?

I don't have any advice but i have also been trying to find out the answer to this, and have been getting mixed responses

A gynaecologist told me that it reduces the number of people who tear, but when they do tear, they are harder to repair well as they are so swollen. Dont know if true though.

Hi, I've never heard of this before BUT I have had 2 water births and have never had a tear, I'm slightly worried now as I'm planning on having an home birth just on my bed, I hope that it doesn't increase my chnances of a tear, if any other mums know the answer and it's true I'm going back to the hospital ??

I had a water birth a couple of months ago and had a second degree tear, but a mild one (if 'mild' makes any sense here). The thing is, it's impossible to know how it would have been different if I'd not been in the water. Perhaps I would have torn more, perhaps less. I would say though, that I only asked for the pool on a whim on the day and it was great. Would definitely hope to be able to use it again if I have another baby. I also think the fact that I can face thinking about another baby means I had a positive experience.

Of course, a whole load of factors and luck go into that and not just the pool. I'm tying myself in knots here but I think what I'm trying to say is that birth experiences vary hugely and it's hard to pin it down to one or two factors, or to control the outcome.

Good luck with yours! I hope it all goes smoothly whatever you go for.

Oh, cross posted with others. Well, I can only answer from my one experience, but had no problems with repair. Stitched up by the midwife and no issues since. It hurt while I was being stitched, obviously, but not that much afterwards.

I had one normal birth and one water birth and had a second degree tear both times. They were bog-standard requiring four or five stitches each time and healed quickly without issue. I guess you're built how you're built and if you're going to tear you're going to tear but water does make everything so much more bearable at the time.

That's because the current research shows mixed results. Being in water doesn't seem to make much if a difference overall but if you do tear in water it is common to wait for a bit before stiches arecdone so the skin is not water-logged.

I was discussing this with a friend who is a gynaecologist too. She said the water can be supportive but also that she wouldn't spend too long in there as it can be a bit like when you have a long bath, the top layer of the epidermis swells up and then goes wrinkly = less elasticity and possibly worse tearing. Women who have water births seem to have fewer tears but maybe this is correlation rather than because of the water.

I got in the pool for the last 15 mins and it was great. No tearing at all and crowning was very supported and controlled. Was second baby though, so maybe DD1 paved the way!

I was in the water only for the second stage of labour, so not more than about ninety mins and had a second degree tear that was stitched up after and has healed fine. The position you give birth in is important too as some are worse for tearing than others.

At the moment the risk factors for severe tears do not include water births. There might not to be enough research on the topic.

Known risk factors are:
-Asian ethnicity
-first-time mum
-big baby (4kg+)
-shoulder dystocia
-back to back baby
-prolonged labour
-instrumental delivery (ventouse and/or forceps)

Risk factors to sustain a second severe tear for a second child:
-Asian ethnicity
-forceps delivery
-big baby (4kg+)

www.rcog.org.uk/en/news/rcog-release-updated-guidance-on-the-diagnosis-management-and-treatment-of-third--and-fourth--degree-perineal-tears/

www.rcog.org.uk/globalassets/documents/guidelines/gtg-29.pdf

I've had 2 water births, and only had 'grazes' both times. But that could easily be down to luck or genetics.

Being in the water felt so good though, for me at least it seemed to take the edge of the contractions. I also spend a lot of time in the bath during pregnancy!

Well with ds1 I had an episiotomy, ds2 I tore and needed stitches, ds3 I tore but didn't need stitches.

Ds4 no tearing and he was my biggest baby 10lb 13oz with a head circumference off the chart. The first three I had on dry land, no 2 and 3 kneeling up. Ds4 was born in a birth pool, labour was less than an hour. I have always felt the water helped and would go for a water birth again. But I love being in the water, swimming etc preg or not.

I have heard both Btw, that the water helps and that it doesn't with regards to tearing. But ime it helped and tbh even if there was a greater risk of tearing it helped so much with the pain of contractions that I would use it anyway.

DC1 - water birth - mild tear (4-5 stitches)
DC2 - water birth - moderate tear (25 stitches, some internal) but she was spine to spine presentation
DC3 - not water birth but smaller baby - slight tear, didn't bother stitching (but I wish they had in retrospect, as I'm convinced I have some scarring which is a bit sensitive)

I'm not sure there is a correlation, more the luck of the draw! I would rate water births though (would have had one for DC3 if he had been slower in arriving)

That's interesting about Asian ethnicity being a risk factor for tears, does anyone know why this is?

I've heard both too.

I spent a lot of time in the birthing pool but didn't actually give birth in there as DD's heart rate dropped, so I had to get out for her to be monitored more easily.

I ended up having an episiotomy, but I'd been struggling to push her out as she was positioned a bit diagonally. (A lot of "oh there's the head baby's coming out - oh wait no it's gone back in".) Plus with her being in distress she really needed to come out ASAP.

I would echo what pp said - the water helped a lot with pain so it's worth a try. I suppose in theory you could always get in for a bit and get out if you were worried there was a higher risk of tearing (though from experience it is very hard to get out of a birthing pool with a baby's head halfway down your birth canal!).

I sustained a very bad 2nd degree tear after waterbirth with my first baby 7 weeks ago. I don't think it was entirely down to the waterbirth, but think it did contribute to the severity. I would however still have a waterbirth again!

My baby wasn't big (7lb3) but was back to back. He turned whilst coming out, causing second degree tear of perineum and corkscrew internal tear radiating from inside vagina to labia. He came out v fast whilst turning (head and body born in one contraction). Had I been giving birth 'on land', the midwives would have been able to use hot compress on perineum which would have possibly minimised the perineal tear. However I would have sustained the internal and labial tears regardless.

I think the benefits of a waterbirth far outweigh the possible problems - warmth for pain relief, takes weight of your body so you can be in much better birthing positions, baby is brought right to you out of water much quicker than on land.

Risks are always just risks rather than definites. My own example defies the risks as I had a ventouse, dry land delivery of an 11lb 2oz (5kg) baby with no tear. Not sure what that says about me really...

3C tear, I was in the pool from about 6cm so about 4 hours. DD shot out all at once and was 9.5lbs.

I have had two tears in a pool... First time was a 3c tear about 25 minutes before DC even arrived, so gave birth on land... Second time was a 2 tear right as DC arrived, so stayed in water throughout, and they only noticed when they checked me on the bed after. Impossible to know what would have happened if I'd been on land... Both mine were over 4kg, so I fall into the risk categories...

I asked a midwife and she said 'as soon as you feel you're in labour, get straight into the water, it can help' after I asked her about being cut/tearing again if I had another baby. I had an episiotomy, and that extended out (from what I can tell!) to look like an upside down Y, 2 labial lacerations, and an internal tear, all of which wasn't mentioned to me. So no thanks. I'd rather give birth twice, without trauma, than have stitches EVER again!

Reading some of these posts, it makes sense how water can both help or even make it worse! Might push to be sterilised, to be honest!

I didn't want to get in straight away. I think I thought that it'd feel better if I waited till it got more painful. I was also aware that I didn't want to be in the water too long, as I have heard that it can slow things down (no idea how true that is, it wasn't for me).

We need some scientists who can explain how being in the water affects the skin. There must be graphs somewhere (sorry, maths geek ) as it does seem that it may both help and hinder.

I had a water birth.

Third degree tear.

Didn't have any of the risk factors either, other than first time mother. I don't think my anatomy was up to the job, personally, and I would have torn badly no matter how and where I delivered.

1st vb, a vbac, no tears, just some nasty grazes. Dd was 8.5 lbs and born very fast, 2 contractions. The pool was amazing for me - wouldn't have managed without it

I had a water birth, first baby, no tearing. DS had quite small head though, so who knows, maybe that was the main reason. I do think however that it is easier to get into comfortable position in water, which can reduce tearing (just my personal opinion!)