Exercises to avoid tearing/issues?

[squizita]

Hi all- I am coming up to the big 12 weeks. I have had 3 losses before this, thankfully am now on medication which has massively improved my prognosis (thanks NHS!). According to the calendars on these things, it's time to start thinking ahead (gulp!).

Due to my previous losses, I'm quite anxious about my body 'working' like a normal lady's when the day comes (my MWs have been fab and referred me to a nurse for support, again thanks NHS - I feel very lucky as I know it varies wildly town-to-town).
One thing I'm worried about is, if you read birth stories, 1st baby always seems to involve damage to mum (and yes, I know no one puts their bog-standard-average stories on websites, it's horrors or amazingly easy only). I understand that about 50% of first-time-mums tear/graze (or are offered an episiotomy) to some extent and you cannot guarantee anything at all ... but obviously would like to do what I can, if anything I find it reassuring to know whatever happens I've done "my bit" properly if that makes sense?

I am starting to do pelvic floor exercises every day.
Someone I know who has 'big babies' also mentioned an exercise where you use your thumb to 'stretch' your fanjo (tmi) to minimise tearing. Could anyone give me more information on this - when to start doing it, any links etc'?

Also, are there any other things I can do to get myself ready?

I used perineal oil from Gowri Motha's gentle birth method site. Although a bit shocked at the price on there!

I'm sure it was about £6.99 back in the day, and she would also answer emails and enquiries about her method without charging for them

If you want confidence and a feeling of control, though OP, I would recommend her birth preparation CD. It was very relaxing and confidence building.

Also from my experience only, don't give birth kneeling unless you're in water. I think this was not great for me. Fine to be on knees for the first bit, but I think pushing lying on your left side is gentler on your body. Also then the midwife can see what's going on and direct you, which I found really helpful.

Thank you, yeah it took 2.5 hours to push him out because of it!

I totally understand your need to plan, I was the same.

Massage, pelvic floors, exercise etc but also listen to the midwife, tell them to tell you when to stop pushing as that's a crucial moment!

Thanks all for your kind and reassuring advice.

Stockhausen because of my clotting condition, not sure I'm allowed a water birth - but I will ask! You never know! ... I'd rather be in the birth centre than the ward (though still want to be in the building of the hospital, due to the issue personally a home birth would concern me).

I did some perineal massage with DS1, especially after his head measurements (front to back) went over the 100th centile! I think i used olive oil.

I didn't have any tearing, only a slight graze, despite being induced - but the MW who cleaned me up said that giving birth on your left side is the best way to avoid tearing (and I'd been on my left side right up until the last push). I don't know if that's true, but it's what she said (and if it IS true, why don't they tell more people?!)

With DS2 I had more problems getting him out - he got stuck behind the anterior lip - but when I was turned onto my back, he dropped clear and came straight out on the next push - again no tearing but a little bit more of a stingy graze.

I did the perennial massage. I used olive oil and getting 'stretched' the skin. It worked, no cuts/tears or grazing. Although a 'friend' kindly pointed out maybe I just have a massive fanny

I've been assured I don't, so the massage must work

Gently not getting

I did do perineal massage but it didn't save me from a tear in the end. I had an attempted forceps delivery followed by an emcs. My tear was not severe (the are graded according to severity - mine was a 2) and had absolutely no discomfort or issues with it healing. Perhaps this was because I was distracted by my section scar, but I don't think so. I know many women who have had a tear, many are very very minor so please try not to worry too much. By all means try all the suggestions here but I do think there's a bit of luck to all of it in the end. I was so worried about tearing but it turned out to be the least of my issues in the end

Also, I did hypnobirthing with DS1 which I found excellent for the general fear-removal and relaxation purposes, although I can't say it helped much with the pain!

And, fwiw, I also have a blood clotting problem (factor V Leiden thrombophilia) - not that it will make any difference to your risk of tearing or anything else. :)

The left side rule sounds fascinating - I've heard sleeping on your left side is better too. I wonder why? And if it's the same for left/right handed people (overthinking).

Puds Sounds like the kind of comment some of my mates would make

Thumbwitch I have mild APS so similar risks/treatments, hearing it shouldn't interfere with birth v reassuring thanks! :)

I had some nasty tearing with DS1, and read 'The Perineum in Childbirth' which was a study by the NCT, and the best I could find in the pre-internet days when DTDs were on the way. Hopefully, there is more available now.

There was some info on perineal massage, which I did, and also about how the head was delivered, so I made sure that I knew exactly when and how I should be pushing. I must admit, this was easier to understand with the experience of already having one child.

DS1 arrived in 3 hours, was a little distressed with his rapid arrival and had his hand over his head. The midwife was anxious to get him out and I think I may have pushed too much! Anyway, the DTs arrived rapidly, mostly under their own steam, and with just a little graze. I felt it was worthwhile because I knew what I was doing, in rather a chaotic situation!

Agree about the local anaesthetic.
Also, the yoga/pilates - you need to know when and how to let go as well as exercise the muscles.

We did some PM (DH was very helpful!) and dd was also born in a pool.
Only had a small graze and similar also with ds (dc2)
So maybe one or both of those things helped
And I definitely agree that it's good to feel you've done what you can, or at least had a go x

My midwife said that to me a few weeks ago Juggling- to try absolutely everything, as then you feel mentally prepared on the day- and this is 80% of the battle.
I'm like a girl-scout-nerd, i'll be doing the PM, Hypnobirthing, prenatal yoga, the Raspberry leaf and ALL- if it doesn't work then i'll have no regrets either..

I did some PM and used the Epi-No. DS was a (very quick) waterbirth. Both MWs checking me out post birth marvelled at my lack of damage I was as high as a kite on endorphins (only had two paracetamol for the birth - it was quick, not a brave choice!) and kept raving on about the Epi-No....DH thought they were going to thump me (or find one to ram down my throat!)

I was also very active during pregnancy.

As Stockhausen said, my body found PG and labour a breeze....DS was IVF and #2 is proving even more elusive so I can only conclude I don't do getting PG well

Would never have dreamt at getting DH involved though, it's a playground not a battleground

Should also add DS has a lovely small head, which after saying he couldn't possibly be mine and DH's due to all his dark hair I commented on immediately after the birth!

I did some fab pre-natal yoga and drank raspberry leaf tea too Chica (in couple of weeks pre-birth, you shouldn't have it too early on?)
Good luck to all x

Vanilla you have me sold on the Epi-no.. such a shame it's so goddamn expensive, but totally worth it really if it actually does work!

Did you get an epidural? I take it you didnt if you had a full waterbirth? I say 'full' waterbirth, my plan at the moment is to labour in the pool until about 8cm and get the epidural then..

Chica no epidural. Not sure the MW believed I was in labour for a long time. Went in to confirm my waters had broken (was having no contractions) but they time she had gone to write my notes up and come back I was naked on all 4s with the TENS on! It took 45 mins in the shower and me begging to be re-examined to confirm I had gone from 1-8cm in less than 3 hours! She let me get in the pool then!

holy moly that's amazing! hope that happens to me!!

i think the key thing is remaining active (like you did) during pregnancy- EVERYBODY says it. How active were you? At the moment i'm walking to and from work which is 30 mins a day, swimming once, and yoga once. I need to up this a little bit i take it?

vallinnapod I hope my future offspring take after me, I have a small round head "like a Brussel sprout" according to DH. ;)

LOL - DH has a small head but we were worried DS may have his wingnut ears which would have got him stuck somewhere

I have a massive head (plus i was a 9 lb baby) but OH has a small Beetlejuice-head (and was a 7 lb baby!) , so hopefully our son will take after him and not me.
Actually, my consultant said the baby does generally does take after the father when it comes to size at birth.. here's hoping!

It's all just luck of the draw on the day really, baby's position, tiredness, how active you can be, mitigating factors.

But really all the advice about being as prepared as you can be, that was the mental key for me, I didn't fear birth at all. In fact, I used to collect birth horror stories so I knew what I would be dealing with.

Hypnobirthing (laisy daisy classes) were my saviour in the end, I felt the breathing and visualisation techniques kept me really busy.

And luck, luck, luck, luck.

Fast forward to my labour and me telling the midwife I felt the urge to push and her saying "no my dear, too soon, you're too calm" etc etc and once I begged her to check I was fully dilated and ready to go.

Big headed DH here so it was a good 2 hours of pushing.

I have heard it's more to do with the size of your cervix than the babies head though ... Not much you can do about that ...

Lockie I'm intrigued by Lazy Daisy (a few RL friends had odd experiences with more extreme/strange NCT groups, and have heard through the grapevine Lazy Daisy + NHS Ante Natal might suit a pessimist like me better).

If it helps I'm a total pessimist and can't speak highly enough of my experiences of daisy classes. I still have a close relationship to the instructor now and baby is 8 months.

I really liked the birth education (they tell you about he physiology of birth and how each breathing technique, movement etc made each part of the process work and progress). I personal liked how practical and sciencey it was and didn't find the meditation five minutes at the end to woo

They also did a couples workshop which was a condensed version of the techniques and birth journey, in about two hours, for you and your partner/birthing partner so they could remind you/encourage you during labour.

Talk about types of birth, options for pain relief etc but no bias at all. And no judgement on any aspect of birth choices.

It was really like a yoga class mixed with a biology lesson. I'm an information nerd so loved all the science !

That Lazy Daisy things sounds amazing. It's the bias i have a massive issue with. I'm listening to Gentle Birth CDs (hypnobirthing) and considering going to a workshop of theirs also, but 'epidural' is a dirty word with them so feel like you only get one side of the story.