Is there any way to prevent tears???

[RaRa1988]

...or an episiotomy? That's the one thing I'm REALLY afraid of with regard to the birth . I know much of it is probably down to chance, but is there anything I can do to lessen the risk?

Perineal massage is supposed to help lessen your likelihood of tearing. Google it for full instructions!

I know the thought is really frightening but horrendous tears are quite uncommon. And episiotomys are usually only performed if there is a need to get baby out very quickly-they are certainly not routine any more.

I had a small graze with my first baby (needed no stitches) but had a second degree tear with DC2. Pain and healing wise there was little difference for me.

I did perineal massage for four weeks but still got a second degree tear. However the midwife said I was lucky not to get a third or fourth degree one as I have a very short perineum, so I'm convinced the massage helped. I was a bit sore for a few days but kept taking nurofen so it wasn't so bad, and after a fortnight I felt fine.

When I went into labour I was terrified of tearing and the lovely student midwife said to me, if you concentrate on my voice and listen to me, push when I say push and stop when I say stop you will not tear..... I swear to god it was like there was only the two of us in the room and I focused on her soooo intently, I completely followed her instructions to the letter and I didn't tear, she was a big baby too 8lb 13oz she was also back to back. I have also subsequently had a 10lber and didn't tear either and I like to think this is again because I closely followed what I was told and not because I have a bucket fanny!!

Perineal massage is meant to help.

Being guided on pushing to go gently if things are coming fast.

But even if you do those things, the vast, vast majority is luck I'm afraid.

Tears really aren't that bad.

I don't have any advice on how not to tear but I just wanted to come and reassure you - it was the thing I was most terrified of before my first child was born. I did tear and in reality it wasn't the horrible, terrible thing I'd imagined. Try not too worry too much.

I've had 2 episiotomies and honestly, they were fine!

Listen to your midwife. When she says stop pushing, stop.

There's a bit where the midwife tells you to stop pushing which I found really hard but another midwife told me to pant which was much easier to do, I had a really fast labour and avoided anything too bad.

I've only done a handful of episiotomies in the past 10 years of practising as a midwife. Try not to worry too much op (easier said than done).

Push when you are supposed to push and stop when the midwife tells you to...even though you will have the urge to carry on!

I agree with what everyone has said but think you might have to accept that what will be will be. I did the perineal massage for weeks before birth, I stopped pushing when they told me to, but my baby was big and back to back and I ended up with a 3b tear. Not much fun but actually not as bad as you might think - if you do tear, you will get well looked after. I got 'repaired' in theatre under spinal block and didn't feel a thing, got a private room on the post natal ward, seen by the consultant twice before I went home, and seen post hospital by both a consultant and a physio. Although it's not ideal, sometimes you can't avoid a tear - but in my experience, the care you receive is very good.
I have no lasting problems and am pregnant again and planning another VB.

Rose - I presume for the instrumental deliveries (particularly forceps), it wouldn't be you doing it though would it? Wouldn't it be the registrar/consultant about to do the instrumental? Totally get your point about vaginal deliveries though.

I think that there are so many horror stories about tears on MN that it's easy to forget that third or fourth degree ones are relatively rare. And also, we mainly hear about the ones that don't heal properly or get infected etc. Before birth it was the one thing I was most terrified of but in the end it wasn't as big a deal as I feared, the midwife was meticulous about stitching me up and (touch wood) I feel fine now.

Ive had a 3rd and 2 2nds, for the 3rd it was a theatre rerepair job and the next 2 were done by mws. The recovery for the 3rd was a little longer but no problems. I did ask for an epesiotomy during 2nd labour if it looked like I was going to tear but in the end they didn't get the time. I found after no1 that I coped better having the mindset that it will happen no matter what which helped me relaxed about it and not as petrified about ending up in theatre again.

Yes, you are right that most assisted births are with an episiotomy. But you are more likely to have had an epidural
If it's going that way. However, I am seeing more doctors not doing routine episiotomies, especially with ventouse births.