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Childbirth

Share experiences and get support around labour, birth and recovery.

Original poster

Any ways you can avoid tearing? Really don't want to tear this time round...

25 replies

Pannacotta · 11/03/2007 13:26

Does anyone know of any good ways to avoid tearing when giving birth?
My DS was born at home after a relatively fast and straightforward labour. The second stage was pretty quick/intense and he was born only 15-20 mins after my waters finally broke. He was a big baby, 9lb 3, and more or less pushed himself out, I didnt really have to intentionally push IYSWIM.
But I did have a second degree tear which the midwife (very nervously) stitched, which seemed to take her forever. The birth was ok but having stitches was not nice at all. I found it v traumatic - have a bit of a needle phobia and hated having a local just after giving birth (who wouldn't?)...
I did do perineal massage last time round when pregnant (plus pelvic floor exercises/yoga/swimming) and gave birth in a kneeling position so I felt I did what I could but still ended up tearing.
I am really desperate to avoid tearing or at least having stitches this time round.
Can anyone suggest anything which might help?
Do you have to have stitches with a 2nd degree tear or can you leave it to heal on its own?
TIA...

OP posts:
lulumama · 11/03/2007 13:48

water is excellent for supporting the perineum

as is an upright position...kneeling, all fours is also good...

am just reading 'active birth' by janet balaskas, it has some excellent advice for ways to prepare the body for birth ...and for good positions to open up the pelvis and get the perineum really relaxed

might be worth getting hold of a copy from the library
even if you do tear again, it is unlikely you will have the same nervous midwife again! her nervousness sounds like it made it more traumatic for you

octopussyintummy · 11/03/2007 13:54

I have got some massage gel and planning an active birth in hospital. Had a huge episiotomy last time - big OP baby. Would like to avoid a tear too.

I am suffering from pelvic floor/ perenium confusion - are they the same thing? If so my perenium doesn't move at all when do my pelvic floor exercises - am I being dim?

Original poster
Pannacotta · 11/03/2007 13:55

Thanks lulumama, will get the book, I like J Balaskas.
I was hoping giving birth kneeling would have helped last time (was on my feet or knees throughout) so will have to see what else I can do.
Yes the midwife was terribly nervous, despite being v experienced, she put off doing the stiches for several hours and then washed her hands about six times before starting, by which point I was getting mildly hysterical!
Do you know if you can leave a tear to heal, so avoiding the stitches altogether?

OP posts:
Loopymumsy · 11/03/2007 14:18

This reply has been deleted

Message withdrawn

lulumama · 11/03/2007 14:30

friend has second degree tear after 3rd birth, (home birth) , tore the same place she had torn before, midwife happy to leave it unstitched and it healed by itself...

Scootergirl · 11/03/2007 14:32

I tore really badly with DD and was the same as you - desperate to avoid it second time!
I found the best thing was to learn the breathing so I could pant as DS's head was coming out to try to slow it down and it worked a treat. No tear!
Good luck

lulumama · 11/03/2007 14:34

pelvic floor is the muscles , the perineum is the skin between the vagina and anus...

shows the difference between tears

4blessings · 11/03/2007 14:47

Hello pannacotta
my 3rd son was born v.fast at home (top of the stairs!) delivered by daddy! I was SO relieved that he realised I was having the baby HERE AND NOW on our own..as he had kept chanting "come on nicky we gotta get you to hospital!" car running outside!
That when he bent down and said "Its coming, O.K I'm gonna have to deliver it!"
I jus finally pushed without thinking about it and tore! had to have stitches for the 1st time and was terrified of repeating the ordeal when 4th baby was due....so I decided to keep a cool calm head, as I was fretting a lot in my head and went over due for the 1st time! and decided that when I was ready to deliver I would ease the head out slowly hoping this would allow the skin to stretch slowly! The next morning V.early I was at the top of the stairs in full labour again! No painkillers again!!
and on all fours my other half shocked this was happening again! the midwives on red alert were still on their way to us! but I had been holding the baby in for over 10 mins literally with tissues on the top of its crown and we just had to deliver it alone again...I started to push with the contractions and then I resisted pushing and squeezed the babies head very slowly out...
so slowly DP sain "thats it the heads coming you can push!" (as if I wasn't aware of this fact! but I just Breathed really deep and slow with all my being and I DIDNT TEAR! I was so happy not to have stitches,She was over 1lb bigger than her 3 brothers, and she'd had her hand pressed against her cheek too, so I would of torn if I hadn't made all that effort to slow the delivery and work against the contractions..sorry its so long winded a tale! hope this helps you!

4blessings · 11/03/2007 14:52

Ohh jus wanted to add that they have to stitch if you tear an artery ( I think thats what its called!) as I had, to stop the blood loss.. but I think you can argue to not be stitched if its not causing large blood loss

mears · 11/03/2007 14:57

There is no 100% guarantee that if you do 'xyz' you won't tear. Controlled delivery of the head can help enormously though. As 4blessings decribed, 'breathing out' the head can help by letting the tissues slowly stretch.
To be honest I think your problem was more the repair. A tear should be sutured as soon as possible after birth as the area is still a bit numb and getting local injected is not so painful.

As far as leaving a tear goes - the recomeendation is that any tear involving the muscle should be repaired as there is no evidence that it is better to leave it. We used to leave small tears but I attended a study day that demonstrated one person's small tear was another person's large one. Women had problems with healing subsequently.

There is less risk of infection and ongoing pain if the tear is repaired properly.

It certainly is your choice whether you have stitches or not. I would advise a second dgree tear is stitched but it should be done immediately.

octopussyintummy · 11/03/2007 15:29

Lulumama

Sooooo - where are the muscles? I assume they are the ones I use to stop myself going for a wee - but when I do my pelvic floor exercises my tummy and bottom also tighten which is apparently wrong - so am I using the wrong muscles. Also how do you know if they are well toned - very keen to know after the complete lack of bladder control for a few days after ds2!

lulumama · 11/03/2007 15:43

here is a picture! if you google, or get a good book about birth, there will be in depth diagrams of the pelvic floor....the muscles are the ones you use to stop the flow of wee....

octopussyintummy · 11/03/2007 15:47

I think I am doing it right! Thanks for that - never realised orgasms were so good for your pelvic floor !

lulumama · 11/03/2007 15:49

oh yes ! also, sex in late pregnancy can be vereeee satisfying due to the increased blood flow to your fanjo....

Doulaklaw · 11/03/2007 16:29

You might like to read this, Pannacotta: www.glorialemay.com/gloria_lemays_courses.htm#intact_perineum

HTHs

mears · 11/03/2007 16:48

Here's Doulaklaw's link

Doulaklaw · 11/03/2007 16:59

I realise that, being new to MN, I am still to get the hang of this link thing!

I'm just going to practise a link here so bear with me if I get it wrong, again....

Gloria Lemay

mears · 11/03/2007 17:25

well done

Doulaklaw · 11/03/2007 17:34

Thanks

I'm used to doing things another way on another board, you see...

I'll learn!

Original poster
Pannacotta · 11/03/2007 19:21

Thanks everyone, loads of great advice...

OP posts:
cupcakesgalore · 12/03/2007 10:45

If it is any comfort I had an episiotomy with no. 1 and a 2nd deg. tear with no 2 - BUT was determined not to tear with no 3. I had a water birth and made a real effort to control myself when the baby's head crowned. Did lots of shallow puffing. Whether it was the water, me or the fact that 1 and 2 were 9lbs 11 and she was only 8lbs 4 i don't know - prob. a mix of all 3. So you won't necessarily tear - the water was fab. though. Good luck!

Runninglate · 12/03/2007 11:59

Water and breathing.

Definitely.

Gingerbear · 12/03/2007 12:26

have you heard of epi-no?
epi-no website

TwirlyN · 12/03/2007 12:49

I'm quite surprised no one has mentioned Wheatgerm oil yet. My midwife told me about this when i has DS 1 now 5. Rub it in everyday from about 36/37 weeks. Worked a treat. I then went on to have DS 2 now 3 in Spain (no Dh allowed, no pain relief of any kind offered, strapped to a bed during labour). Anyway I heard that its normal for most women to be cut during the birth. I checked with my midwife, and this was confirmed. So I had wheatgerm oil sent out and used it again. My midwife and everyone in the hospital were amazed, they couldn't believe i didn't need to be cut, or had any tears. At 8.10 ozs the Spanish thought DS 2 was massivehugh. Its has also worked for friends of mine. Good luck

elibumbum · 12/03/2007 17:33

This is a really interesting thread - I found the tear/stitching business very unpleasant so I'm going to store this info for next time (not planning on being pg again for a while yet!). I was told by a former midwife that you should rub in a good quality vit E oil into your scars even before the next pregnancy. Suppose I should think about getting into training - can anyone recommend a good oil?

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