Tips on not ripping down there during labour?

[Lemonmiracle]

Hi, I'm currently pregnant with my 2nd baby and due at the end of the year.
With my first, I spontaneously went into (active) labour and my DD was born within 4 hours maybe less. She was tiny, 5lb 5 ounces with the smallest little head I've seen but the tearing and stitches was absoloute HELL. I WOULD LABOUR 50 TIMES OVER to avoid this again. I had 2 second degree tears toward the lower part of my vaj and had a clitoral tear which thankfully all healed but getting stitched was honestly so extremely painful that the midwives were actually getting annoyed at my reaction. Does anyone have any tips for not tearing down there I would really appreciate it

It has been shown to help:

pubmed.ncbi.nlm.nih.gov/32399905/

I had tears with my first 2 and really wanted to avoid it with my 3rd. I did yoga for childbirth classes and the teacher recommended perineal massage with jojoba oil, which I did. It can get difficult to reach properly when you're heavily pregnant so get your partner to help! Also I laboured as upright as possible and gave birth kneeling and leaning on the side of the bed at home. It was a pretty quick birth and my 3rd baby was 8lb 5 but no tears! It made such a difference to how I felt after the birth. I really think the perineal massage made a difference.

I don't know what the latest advice is about raspberry leaf extract but I took it for my 3, supposed to promote elasticity.
I know you mustn't start taking it too early, a month before due date I think.

I had no tears or cuts internally or externally.
DD1 7.5lbs, DD2 7lbs, DS 8lbs ( a bit of leeway by then I imagine!)

@WhatMe123 oh dear, did you need stitches the second time too :(

Will be giving perinneal massage another go this time, maybe I should ask DH as I can't get the hang of it. Thank you ladies x

I used a perineal oil beforehand. Apparently I did tear and I did have stitches but I didn't really feel it afterwards, it was odd, it wasn't painful apart from deep inside, as per usual after birth. I would definitely avoid a CS if you can, so much longer to recover.

My midwife recommended epiNo in my second pregnancy and it worked for me.

No tear unlike the first labour, just a small graze that healed by itself in a couple of days.

I have given birth twice naturally with no tearing. I would say just listen to the midwives instructions to the letter!!!

OK, so I had a very similar first labour to you. I hadn't done any perineal massage as the only time I tried it gave me awful thrush afterwards. DD1 was 5lb 12oz, fastish labour with quick pushing stage. I had a 2nd degree tear, a urethral tear and 2 x labial tears (didn't even know they were a thing!) I had gas and air, and spent the whole labour on my hands and knees but the crowning and tearing pain was unbelievable.

When I fell pregnant with DD2, I was offered a c-section because she was breech and I was secretly a bit pleased at the thought of avoiding crowning.

HOWEVER, I went into labour before my c-section and it transpired that DD2 had turned head down so I went for a vaginal delivery. My labour was 1hr, I barely had time to get undressed, let alone onto the bed so laboured leaning over the bed, gas and air only, and she literally popped out like a bubble popping - one push was all it took. No burning or crowning pain - although the contractions were very intense as they were so fast. She was also bigger than DD1 as well at 6lb 3oz. One minor tear that I almost got away without stitches, except it was a little too close to the urethra so they stitched anyway.

The consultant midwife I saw to discuss breech options told me that if you have had a vaginal delivery once, the second one is often much easier. So it can be a very different experience to the first. Obviously not for everyone, but just to say that it can be an easier experience for some.

Just to reassure you I had 2x precipitous labours with the second an hour start to finish. I had a large 2nd deg tear with baby 1 mainly because I kind of panic pushed forgetting my breathing but it was much better with baby 2. I needed a couple of stitches but the tear was very superficial and nothing like the first time.

Breathing slowly helped, but also I recall a thread on here recently where most people said their second births were MUCH better for tearing.

This.

I tore with my first because I had a horrible midwife who insisted I get in to the semi seated position so she could monitor progress.

Next one I discussed my wishes with the midwife as soon as I arrived. She was happy to follow my lead. I knelt for the delivery and it was fine. No tears at all. I did the same for the third.

I would advise making your wishes known. Laying back restricts how much your vaginal opening can expand. Being upright on your knees allows expansion in every direction. It also allows gravity to play its part.

Edited to say - mine were also all very quick labours. 4.5 hrs, 3hrs and 2.5hrs so speed of labour wasn't an issue.

If it helps, I suffered a 2nd degree tear and found the stitches and recovery from the tear absolutely horrendous with my first. With my second, I really wanted to avoid tearing. I realised that with my first as he was crowning, I felt like I just wanted him out and did a massive push to get his head out quickly, which caused the tear. With my second as she was crowning, I had to try really hard to stop actively pushing and instead tried quick panting with slow and gentle pushes now and again. This gave the perineum time to stretch without tearing, and I only suffered a slight graze with her. Recovery was a breeze.

I'm now pregnant with twins and feel super apprehensive about delivery. However, it will look.

Wishing you the best!

Yes, being on your back is the worst position to give birth in (it's crazy this is what's portrayed on TV and movies!)

I tore badly with my first, but they took me into surgery afterwards and I had an epidural pre surgery. Second baby I tore but not too badly, so it doesn't always follow that you'll tear in the same way. Demand pain relief. It's ridiculous that women are expected to go through pretty traumatic surgery without local anesthetic.

@PaperBee its a lot more complicated than that and the findings don’t make a huge lot of sense!

Almond oil on your perineum every day after 37 weeks

Research usually is complicated, especially with self-administered interventions, but from a quick look at the numerous papers that come up there are various positive findings, some negative (but often just not reaching significance on some measures rather than showing no group difference), and most importantly a few reviews and metaanalyses, like the one i posted, seeming to show various positive effects, though mixed in which. Certainly enough positive evidence that it looks worth a try to me, and not at all the case that “perineal massage hasn’t been shown to help at all in research, sorry”. Say the evidence is mixed if you want to represent that there’s room for doubt or argument on the details honestly rather than a flat 100% rejection and a second party summary of one paper with negative findings rather than a review or acknowledging the number of papers that do report positive findings.

My midwife said being upright or at least not on your back, all fours is good. Warm compress or in a pool.

Honestly I 100% believe you that it was the most painful part of birth and the midwives absolutely should not have treated you that way. I’m so sorry that that happened.
A midwife has no more rights to put their hands on you without consent than a stranger on the street. If you want to wait for theatre you can absolutely insist on that.

But you also have some great advice on this thread, so hopefully you will not need that!

Think UFO (upright, forward, open). First birth I was leaning over the side of the pool, second standing over the edge of the bed. Basically the total opposite to lying down on the bed. You want to use gravity to your advantage and be mobile so your body can move in whatever way it wants. Naturally it will want to me something like on all fours, where the pelvis can open up. If you are in a good position, you won't have to force the baby out, which is often what causes the damage.

Well yeah of course, can anybody really say massage definately helped though? General consensus is it can't hurt to try but honestly if you don't feel comfortable with it don't bother. It's only going to add anxiety that you definately don't want during labour. If you aren't in a comfortable position and breathing well to get oxygen flowing well to the muscles trying to use force to get the head out then yes it's very likely to leave some trauma, oil or not.

Hi everyone just wanted to update for anyone interested. I gave birth this week to a healthy little 7lb baby, no tears no stitches but a few tiny grazes that have actually already healed.
He was a little bit early so I didn't get to try everything suggested on here but I ate 7 to 10 dates a day for about 6 days before baby decided to arrive and also massaged the area down there with olive oil once or twice before. I also pushed the head out in 4 little pushes which I think really really helped the no tearing :)

Congratulations @Lemonmiracle !

Congratulations @Lemonmiracle 👏🏻🎉delighted to hear you're having a fast recovery

Can I ask if you had epidural? Apologies if you have already said.