Reducing the risk of perineal tears

[Rachwalt12]

Hi ladies I’m 31 weeks pregnant and hoping for a natural water birth if all goes well. One thing I am anxious about is the risk of tearing during the birth. Is there any remedies or advice you could give me?

There is some evidence to suggest that perineal massage can help

www.madeformums.com/pregnancy/perineal-massage---how-and-why/29769.html

Also look at hypnobirthing, poor births and warm compresses (if not using pool).

Also remember this is a part of our bodies that is designed to withstand some tearing therefore it is an area that heals very quick. Unfortunately you only hear horror stories online.

There’s nothing that can prevent tears I’m afraid, although evidence suggests that perineal massage does reduce the risk.

I read an article that said tearing can be reduced if you only push when you feel the urge rather than when you are told to. I had no urge to push but midwife and dr kept telling me to. I had a 3rd degree tear so that made me think there may be something to say for that approach.

I tore both times. It sounds awful but it really wasn't that bad for me. (2nd degree). Big babies. Bloody great heads and I could never do the stop pushing and breathe the baby out thing. I pushed like a lunatic and tore.
Lavender and tea tree oil in the bath was lovely. Good luck.

Perineal massage. I used almond oil and did it every night from 32 weeks, no tears at all either time.

Thank you everyone. I’ve just ordered some almond oil there so il start using that and il also make sure to only push when I need to and I know it’s easier said than done but il try and stay as relaxed as possible. Appreciate all your help x

Apparently a lot of it is down to positioning too so being on all fours or on your side can make things easier, which I'm hoping to do this time. I'd planned to do perineal massage but ended up having my daughter at 34 and a half weeks so only did it once!
I agree with pps that you only ever hear the horror stories online. I didn't tear but did have a small episiotomy as my daughter's heart rate dipped dramatically and she needed to come out quickly. It's a part of your body that is designed to heal well. I used witch hazel gel on my pads, and had lavender and tea tree baths and found that really soothing.

Eating dates is supposed to have huge benefits as it helps make the skin more stretchy! Think you need to eat 6 a day.
Drinking raspberry leaf tea is also supposed to be good but I read its only advised that you drink it after 36 weeks. I know two friends who drank 3 cups a day and neither of them had any tears or stitches and both were first time mums.

Also birthing position can help - mainly not to deliver lying on your back. Being as upright as possible is optimum and allowing your body to naturally push baby out.

Get your husband to do perineal massage to the point of pain and try not to be on your back during labour. Don’t worry too much about tearing though, tearing is often better than an episiotomy — I wouldn’t have one.

I had a 2nd degree tear and honestly it was fine. It has healed well and no issues.
I was petrified about tearing and I wish I'd have known it really isn't that bad.
3rd degree tears are relatively rare.

@Graduate223 with all due respect, that is an ignorant comment. If your baby's heart rate dipped dramatically on the way out and the doctor and midwife said it was time critical, you're seriously saying you'd refuse? That could put your child's life at risk.
Yes, episiotomies can be tricky to heal, and there's a reason they aren't given as standard anymore. But don't fear monger. It's perfectly possible to heal quickly and be fine!

I did perineal massage, ate dates, drank buckets of raspberry leaf tea and didn’t tear - not convinced if it was any of those things or just luck, but felt good to at least be trying things to help.

I drank buckets of raspberry leaf tea but unfortunately got a 3c tear. I was in my back though and she was back to back. My pushing stage was very quick, about 7 mins which is what probably caused mine!

Dates is about length of pregnancy and cervix ripening.
No links to tearing

evidencebasedbirth.com/evidence-eating-dates-to-start-labor/

Honestly, there's not much you can do other than hope your baby is in a good position and stays in a good position throughout labour and birth!

Yes, there's some evidence perineal massage can help, but there's only so much it will do if your baby turns his/her head at the last minute or you need an assisted delivery.

I had an episiotomy - took a while to heal, but everything works just fine.

I'm expecting my second now and have some anxiety about tearing/epi, but honestly, I'm not doing much to "prepare"!

My friend used this religiously epi-no.co.uk and was the only one out of our NCT group not to tear/need an episiotomy. I wouldn't fancy it myself but she swears by it!

I tried perineal massage for the first time last night and il continue to do it TIL birth. If it helps then that’s brilliant and I supppse what will be will be. I am hoping to deliver in the water providing all goes well so hopefully that in itself helps.

Try not to have your heart set too much on a waterbirth. It's what most women want but isn't always possible for many reasons. (I don't personally know anyone who had one for first baby)

If you focus on it too much your possibly setting yourself up for disappointment.