Anyone had moderate to bad tearing with one birth, and then no tearing or very little the next? Or any ideas on how to achieve this?

[Astrophe]

I had quite bad 2nd degree tearing with DC1, then an episiotomy with DC2...and I'm starting to feel a bit anxious about DC3 (am 26 weeks).

2nd deg. tear with dc3, after that barely a 1st deg. tear with dc4 (they said stitches were completely optional).

Stand and deliver -- seriously! Best birthing position I ever found.

Standing really? I squatted with DC1 (and had the bad tearing), then sort of reclined back onto beanbag with DC2 (episiotomy).

My midwife has sugested I don't squat this time as it will be too fast and I will need the time to stretch...she says maybe on all fours.

I just wonder if standing would be too fast, like squatting?

Third degree tear with dd1 after forceps delivery and an episiotomy that tore, dd2 no stitches at all.

First birth was with syntometrin drip so I was monitored, and because the battery wasn't charged on the drip thing I had to stay on the bed so birth position not great.

Had dd2 at home, paid much more attention to position, midwife very aware of trying to avoid tearing again (as that would have involved hospital transfer for repair) so she let me through a controlled delivery which involved pushing between contractions, then breathing through the contractions themselves allowing the contraction to push without help iyswim. That meant it was a slow, continuous stretch rather than anything sudden. This gives the perineum time to stretch naturally and helps avoid tearing.

Was there any reason why you had the tear or episiotomy? I had a back to back baby who was born facing the wrong way with ventouse. I did much better with a smaller well positioned second baby, but that isn't too surprising.

I liked being on all fours to deliver, which gives the baby lots of space, and gives the midwives a good view. I didn't have a problem with delivering too fast - quite the opposite - but you know about keeping things controlled at the end, don't you?

DS1 (7.2lbs) came out holding his ear, posterior position, lots of stitches, no idea what degree tear.
DS2 (8.8lbs) posterior but turned last minute, no tears.
Gave birth lying down for both, 1st had epi, so no choice as numb from boobs down. 2nd happened a bit quick once 2nd stage began, so couldnt move (I had wanted to birth on all fours).
So, sorry, probably completely unhelpful, but tearing in previous births doesnt mean you will tear again.
Are your babies big or do you have v fast 2nd stage?

Cross-posted - all fours felt great to me, and I liked it that I could get good feedback from the midwives. I was also told about the polar bear position - similar to all fours, but elbows and hands on the floor, bottom in the air - to slow things down if necessary. It does the opposite to standing up, gravity works against descent, but still allows for good positioning.

DD1 I had an episiotomy and still tore, so ended up with masses of stitches.

DD2, I did exactly as the midwife said, stop pushing when she told me to etc and I had no tearing at all.

The first birth may have landed me with a bucket fanjo, altho I have no problems down below (thank heavens), or I think it was because I had a fabulous midwife and did as she told me.

Good luck.

ZoeC and lljkk - so encouraging to hear.

ZoeC - so is the idea you push between contractions, but not during? Have I got that right? Golly, with DC1 I was told to close my mouth, stop all the shouting and breathing, and push down hard"...which I did. And even with DC2 the midwife got me off all fours as she said it would be "too slow" - even though she new I'd had bad tearing last time. And then she bullied me to have an episiotomy.

So, I guess I need to have a long chat with my midwife this time.

Thanks everyone
Mrs Tittlemouse - that 'polar bear' position was actually what I was doing with DC2 - I didn't know how to describe it though. But the midwife made me recline back to "speed things up" - obviously not what I needed.

My babies were both 9lb, and were both posterior but turned at the last minute.

Walk (or crawl, or squirm about) until you're feeling very ready & then stand and spread 'em. If you don't consciously push but let the uterus get on with it on its own time, it should'nt be too fast, I imagine.

Yes, the contractions had a pushing effect without me, then I pushed between. Midwife guided me. Was actually very fast, which I wasn't expecting. 8 minutes pushing and dd2 was out. Just kept it controlled - dd2 was 9.5lb so I suppose with labour as fast as it was, she could have come out too fast very easily.

Sounds as though you have instinctly known what was right for you, ans all you need to do is listen to you body. Can you get DH/DP to back you up if a midwife is trying to speed things up this time?

I had 2nd degrees with both ds1 and dd, then didn't tear at all with ds2 - and he was 11lb.

I put this down to having been relaxed and upright in a birhing pool with ds2. I wasn't in it for long enough to soften the perineum - barely 15-20 mins, he was fast! But most importantly I did not push him out. I was upright and let gravity to the work.

It was fantastic. The best of my three birhtings.

Have confidence in yourself.

Thanks all, I will try and stick with what I feel this time, and will definately get DH on the case too.

I think the midwife is better this time - I am seeing her for all my visits and (theoreticly) she will be there when I deliver too, wheras last time I had never ever seen laid eyes on the midwife before. This time the midwife is very happy to talk to me about options, so hopefully things will go better.

2nd degree tear with DS.

A graze with DD

2nd degree tear with son, nothing with daughters. Was lying down in hospital for son, upright and at home for daughters. Upright is the way ahead for me.

Nothing really - 'grazes' with DD in hospital lying down.

'A nick' with DS standing up at home after two hours in warm bath - might have helped soften things up maybe.

Nothing at all with DD2 - at home on all fours - very controlled - was waiting for midwife and DD was born as they arrived but hung on for them so no rush.

I had second degree tear with my second birth - natural delivery 6lb 11oz baby. But she was posterior. Had to supported-sit/squat to get her out as her positionwas odd.

With the next one, I had a home waterbirth and a tiny graze. 8lb 3oz baby. On all fours. I strongly feel water and heat soften things up a lot.

Good luck Astrophe

Interesting that people have found water so helpful. I was in the bath for my first labour but had to get out for 2nd stage, which was long, so softening effects would have worn off I guess.

Midwife has said she doesn't want me delivering in the bath this time either, as she wont be able to see whats going on. Hopefully I can stay in until 2nd stage though.

Episiotomy with DS1 - lying on myback on the bedwith continual monitoring

minor tear with ds2 - delivered upright (no stitches) - and he was a bigger baby (8 lb 10)

by upright I mean kind of on allfours on the bed

also a more relaxed first stage - dim lights, minimal intervention -all helped

I don't think that the water had any softening effect on me (like I said, I wasn't in the pool for long enough) but the difference it made was in 3 things:

1 to comfort me enough to help me through transition in a relatively relaxed manner. That labour was the only one of my three where I didn't panic during transition. As with the others, though, I still lost my temper and flung the G&A across the room! But because I wasn't in a panic I understood what was happening and was able to go with the flow.

2 to provide just enough pain relief that I was able to stay connected with my body, not to have to concentrate on coping with pain but to be able to feel what was happening through the pain and to trust my body.

3 - and most importantly I think - to give me enough support to remain upright and in a position that felt right for me. If I had had to keep myself upright it would have taken so much muscle effort that I would not have been able to relax through contractions.

yes, 2nd degree with dc1 which healed very badly, re-tear there with dc2 (made it all better), then no or superficial tears with the next 3 dcs.

For me it was that I gave birth too fast - I was very pro active, upright birth, and I did need to slow down. Mention it to your midwife, put it in the birthplan, etc. I suggested to mine each time that I was always very adamant I needed to push quickly and she needed to be very persuasive in making me slow down. I had to pant quite a bit but it worked.

3rd degree with DD1 after episiotomy and forceps and no tears at all with dd2.
DD1 Was 7lb 3.5 and DD2 9lbs 2.5

Waves to MrsTittleMouse We are on the postnatel threads now come join us I remember you from antenatel (oct due) as you had had a tear and we chatted about it Hope all ok. Cant remember what you had now.

2nd degree tear and lots of stitches with dd. She wasn't that big (7,14), delivered her standing up.

Ds, 3 years later, no stitches or tears! He was bigger (8,9) too.

I did a bit of perineal massage, but to be honest not very much. Delivered ds lying on my side, mw holding leg in the air! It was great, I really felt in control, unlike with dd. Mw recommended me NOT to deliver standing up, in view of previous tearing. I was also much more relaxed - had a hypnobirthing CD with me which really helped, I think,

Good luck.