Waterbirth - how do midwives know if you are going to tear?

[lovelylullaby]

I've always fancied a waterbirth, and was talking about it to a friend who is a midwife. She's always very honest and said that most midwives couldn't quite tell what was happening under water but wouldn't let it show on their faces and would be worried about the baby coming out until it was actually born.

This has put me off having a waterbirth as I'm terrified of tearing. I had an episotomy with DS, which I was happy to have, with just a first degree, but when the midwife was sewing me back up she remarked I was quite thin between back and front.

In light of this I'd much rather have a controlled cut than a tear.

Does anyone have any info about the risks of water birth?

Tearing doesn't hurt compared to the rest of what's going on. I tore with ds1, not with ds2, and really didn't feel any different. It's not scary.

Hi,
Your friend is correct in that the view is difficult with a waterbirth and a mirror does come in handy. However, it's important for the midwife to keep her hands off during a water birth and to encourage the mother to breathe the baby out as gently as possible anyway. Birth in water has is asociated with less perineal trauma rather than more perhaps due to the gentler nature of the births or to the water softening the tissues. If the midwife was concerned at all she would ask the mother to stand to get a better view or to come out of the pool.
Natural tears tend to heal better with less pain than episiotomies.
Lou xx

The advantage of waterbirth is that the perineum is supported by the water and, since you are encouraged to push as your body tells you (should be with all births but isn't), you are far less likely to tear.

I am a midwife and am not worried about women tearing in the pool TBH. You can tell how well a baby is coming and there are no more 3rd degree tears in the pool (research shows that there are less) than on dry land.

Tears heal better than episiotomies as the tissue has torm naturally rather than in an artificial way. If you only had a small episiotomy, it is unlikely that you will need another one.

Oooh that all sounds great! Thanks for your advice. I'm due in a few weeks and hope I get a chance to try the water birth