Tearing - defintely TMI.....

[orangesnlemons]

I'm a nervous first timer, been lurking for a while - and getting quite scared from some birth stories. I am very anxious about tearing when I give birth anyway, but I've seen a few posts about torn labia, which I'd hadn't even considered. I have, ahem, quite large labia - am I more likely to tear? Reassurance needed, or advice on how to prevent it please!!!

Oh you poor thing. I was so scared of tearing in my last few weeks of pregnancy, I totally obsessed about it.

DD had a big head and I tore a bit, it felt a bit like a cigarette burn, you know when someone accidently knocks into you in the pub (or they used to). I almost laughed after because it was nowhere near as bad as I dreaded. With everything else going on, it wasn't a big factor for me. I found the grazing after gave me more hassle than the tear which healed really quickly. Some savlon in the bath helped and peeing with a jug of water.

I think one of the biggest key is to do tiny pushes when the head is coming through with little breathes, but it's not so easy when your going through it.

Comparred to the last month of pregnancy, I found the first couple of weeks post partum quite easy.
Good Luck

ROFL - your size and shape of genitalia has little influence don't worry. Tearing is normally caused when the head crowns and the next push takes the head past the exit without having time to stretch. In normal circumstances the midwives will ask you to pant or not push to give the area time to stretch.

Small tears are fairly common but third degree tears are thankfully a rarity in all but precipitous labours.

You can try perinneal massage though -that apparently helps some people.

Oh and I can tell you from experience that a caesarian is much harder to recover from than a vaginal graze!

Thanks Sushipaws. Glad you found my question so 'hilarious' wmmc. Obviously you didn't have any silly worries when you were pregnant for the first time.

i can second the suggestion for perineal massage as it does get you used to the feel of the baby crowning and can help prevent tearing.

i don;t think WMMC meant to be dismissive at all of your fears

womens vaginas and labia are all different, your body will adapt and stretch as you go through pregnancy and birth....

water is great for supporting the perineum and help prevent tearing

listening to the MW as the head is being born, panting and allowing a controlled delivery of the head is a good way to help prevent tearing of the labia or perineum
not all tears and grazes need stitches, or you might need a couple only

make sure you have a supply of arnica pillules which are great to take after birth to bring down bruising and swelling

also, when you go to the loo after birth, weeing just before you get out of the bath can help reduce stinging or directing warm water over your perineum ( i used a sports bottle filled with warm tap water ! ) can help as can keeping hydrated. and not trying to avoid weeing !

when you go for a poo, hold a clean sanitary pad against your perineum as you might feel a bit like everything is going to fall out after birth !

and many women don't tear or graze at all!

best of luck

Tearing or being cut by the midwife were the two things that terrified me most before giving birth. As it turned out, I've experienced both - with dc1 the midwife gave me an episiotomy as she was worried i would tear. I was on just gas and air so whe gave me a small local anaesthetic. It was fine - i honestly barely noticed it. With ds, I had a 2nd degree tear, but tbh, I think the birth was mismanaged - he came out far too fast and it could probably have been avoided if i'd been in a better position and told to pant rather than push. It did hurt, I wont pretent it didnt, but it's a very short lived pain, a matter of seconds really. It feels like a burning. But once the baby's out, you honestly wont feel anything. It doesnt carry on hurting, as it were (at least not immediately afterwards). The bruising and tear will ache post-birth, but you can take pain killers, and its all a manageable pain. I think the best way to look at it is that if you do have the misfortune to tear (and by no means everyone does) it will mean you're at the end of labour, the baby is here, and quite frankly thats all that will matter.

I tore with both my births and really it wasn't a big deal. They stitch you up. Tell how to keep it clean and within a week you feel back to normal.

Perenial massage can definitely help reduce your risk of tearing.

I had epesiomety and tore too but that was unusual circumstances. Honestly, please don't worry about it. The pain (if you notice it in the midst of things) really isn't much and will heal quickly. Besides, you might get lucky and be absolutely fine!

I think its usually the perineum that tears if its going too. I had a second degree tear as dd was born in too much of a hurry! A good midwife will help support the perineum and ease the head out slowly. Its normal to be nervous.
I tore because dd was in distress and the midwife panicked and told me to push hard. dd shot out two feet and hit the floor
A different midwife would probably have handled it differently.
At the time I didn't feel the tear, you generally don't. Crowning feels very like if you stretch your bottom lip as far and wide as you can plus it feels like its your anus which no-one had told me about! That bit really is over very quickly and the second your baby is out all the pain goes away instantly (for a while).

I was terrified of tearing, it was THE thing I was dreading about the birth which makes me smile in retrospect as the general pain of the contractions meant I didn't feel it when I did tear (2nd degree, no grazes) as it was all generally painful. Gas and air helped a lot.

As somebody else said, I think my birth was mismanaged too as my midwife just said "PUSH! We need him out NOW!" as if it were a major emergency which it turned out it wasn't (he had apgars of 9 and 9) so of course I did and that's why I tore because he shot out too quickly.

So if you speak to your midwife and tell her you're worried about tearing and would like her to ensure as much as she possibly can that the pushing stage is monitored (they can use a warm wet flannel on your perineum as the head crowns to help the tissues stretch) she will do what she can to help you.

But don't worry too much, you'll find that once you're in the last stages of labour you're in a different place, it's all consuming and your priorities will be different, you probably won't be even thinking about a tiny tear/graze, your focus will just be getting the baby out healthy and as quickly as possibly so the bloody pain stops! It probably won't even enter your mind.

And if you do tear, it isn't the end of the world. Immediately afterwards you'll feel so knackered and glad the pain has stopped, and you'll be focussed on meeting your baby, so amazingly you won't think about any soreness down there. You probably won't know you've torn til your mw tells you. If you need stitches, well, they do sting but if you use the gas and air it does take the edge off and you won't need many.

Afterwards your entire down there area will ache and be sore for a while anyway, but if you tear it will obviously make it slightly more sore- but nothing you can't cope with!! Take paracetamol for the first two or three days and be careful how you sit down/turn over it bed as I yanked my stitches turning over awkwardly whilst leaping up to see to my baby (he won't expire if you don't leap up the very second he starts to whimper, btw- took me a few months to realise that!)

And as everyone's said, pee in the bath, or direct some tepid water over the area when you wee. Take fybogel (stool softener) the first few days to help make pooing easier- can't recommend this enough! I didn't take arnica to help with bruising and pain but wish I had. Witch Hazel on a maternity pad can help with soreness too. Any stitches will dissolve within a week or two and quite honestly within 3 weeks ALL pain and soreness was gone and I felt back to normal (and ready for lurve, actually!)

Hope this helps.

I had a 3rd degree tear when i had my dd, and honestly it really wasn't that bad afterwards, i couldn't plonk down on my backside for a few days, had to sit slowly, but all in all i was up and about a couple of hours after the birth (had to be repaired in theatre with a spinal block so that had to wear off).

I had a section with my ds, and i found it awful, the recovery was very painful and long winded (had 2 infections).

I was seriously worried about being cut when pg first time around, ended up tearing very badly, but you know what? at the time you just don't care, you have your gorgeous little baby to coo over, and love is the best anaesthetic.

Thank you ladies, you honestly have made me feel a lot better and less worried - there are just too many people - in RL! - who are dying to tell me their gory stories and how they were shredded to bits. It's good to read these experiences, and especially that even if it does happen that it won't matter that much. Phew. Massage, arnica, painkillers, fybogel, witch hazel, squirty bottle all to be added to my lists!

Just to second all the "it's not as bad as it sounds even if it does happen" posts. I had a 2nd degree tear and tore the cervix (very, very quick pushing phase).

I didn't notice to be honest. I was aware of the crowning sensation, but it wasn't any worse than the rest of the labour. I certainly wasn't actually aware of any tearing at the time.

If things are a bit uncomfy afterward try keeping your sanitary pads in the freezer. Don't stand up for too long (but don't avoid moving either) - if you're feeling really achy and heavy you've been on your feet too long. Maybe buy one of those wheat pack things that can go in the microwave - great to have between your legs during the first few breastfeeds - the after contractions (can't think of proper name for them) made everything a bit "youch" the first few times for me.

Let your eyes glaze over with any gory stories, I did not have a good birth yet ended up with a beautiful healthy daughter of which if I had to do it ll over again to have her, then yes i would and I feel very lucky to have her.

I did not even think about tearing, I had forcepts and had 3rd degree tear and had not read up about it and glad I didn't as all the info I read after scared the wotnots out of me. Pads in the freezer, wee in the bath it all works and though it took quite some time to sort itself out (and I'll never look quite the same down there) it has all turned out fine. I even started running again with the three wheeler a week after the birth as no-one told me not to and my pelvic floor after a 9lb 6oz baby with lots more subsequent squeezes has recovered well

Good luck and just see how you feel, it's YOUR body and baby, hope it all goes well.

Orangesandlemons - wow - sorry I bothered responding.

May you have the birth you deserve.

And to add another story - tore (2nd degree) with both of mine - and like may people, tearing was the thing I was most nervous of. With ds (my first) I had a hard time with pushing, so wasn't hugely surprised ( and giggled throughout the consultant stitching me up - oh the joys of gas & air )
With dd I was TOTALLY in control and did fabulous, gentle little pushes (if I say so myself) - but she had her arm up. I asked the mw afterwards if there was anything I could have done to stop the tear and she said no.
It honestly, honestly isn't as bad as you are imagining

Whomoved was only ROFLing at your description of your large labia, I imagine - not at your (very understandable) fear

Thanks again for all of the helpful advice/reassurance.

WMMC - I have no wish to upset anyone here, there's loads of useful advice on the forums, and I think people who take the time to post are amazing. I just didn't find it too useful to be mocked (especially in my first post). Let's just forget it shall we?

the thought of tearing always scare me, i did with dd1 and didnt with dd2 to be honest there was not much difference on the pain front. panting and not pushing when the head is crowning definitly helps as i did this with dd2 and not dd1 and think it definitly helped.

I was cut when babies head was nearly out.

When his head was coming out there was a stinging sensation for a few mins and that's when I got cut and didn't feel it anyway.

Stitches were fine and the midwife made a neat job.

I agree with listening to the MW at the crowning time - little pants and not much pushing is the way to go.

I have never torn so don't know about that too much, but with ds1 i grazed, and yes, it was uncomfortable. for the first few wees get in a shallow bath and wee, then when getting better use a lukewarm jug of water to pour over your bits as you are weeing.

I too am scared of tearing and this is db3!! you can get cool pads to put in your knickers if you tear to help make things better, mothercare sell them. femepads i think??

Also you can massage yourself with oil(think olive is ok) - insert thumb a little and pull to the back wall, hold until slightly stinging/uncomfortable and then stop. repeat! from about 35 weeks is best i think.

You will be ok, our bodies are designed to do this and you will do it well.