One of the biggest fears many pregnant women have is “What if I tear while giving birth?” I have so many women ask me questions like, “How can I prevent tearing during childbirth?” and “Is it better to have an episiotomy or a natural tear?”
Of course this would be a huge worry for women, after all, as an expectant mom I spoke to recently said, “My friend told me not to have a med student do my sutures because, you know, I’ve only got one vagina for the rest of my life!”
So, what can you do to avoid tearing while giving birth? There are many different suggestions out there, whether or not they work is what’s important.
Perineal massage has been touted by some as the best way to reduce tearing. What in the world is PERINEAL MASSAGE you ask?! It means that someone, most likely you or your partner right?!, will massage and stretch the perineal tissue in the weeks leading up to birth to help prepare to skin and ready it for being stretched out during delivery.
Does it actually work, or are you wasting valuable time better spent…well, not massaging your vagina? Research is out there, but it’s not always conclusive. Some studies show that it can help you avoid an episiotomy, especially if it’s your first baby and you haven’t had any tears or cuts from delivering previous babies. Other studies say that the more frequently you massage, the less likely you are to see benefits, though benefits can still be seen in many instances.
Confused yet?
Here’s what I think: From the births I have attended, along with the anecdotal evidence of my peers, is that most women are more likely to tear or be cut if one of the following is true:
1-they have a long pushing phase and by the time baby is crowning there is so much excitement and intensity that they are not given the option to slowly push baby out.
2-there is distress with the baby and the delivery must happen more quickly. In this case, episiotomies are more likely to occur and caregivers are more likely to have to manipulate baby’s head or shoulders during delivery.
3-Delivery with the woman laying on her back. Some positions are more conducive to an intact perineum. Positions like hands and knees or birthing in water has sometimes proven to be easier on the body.
So, can you actually prevent tearing during childbirth? No, there is nothing you can do in advance to completely prevent it. BUT, during delivery you could ask your doctor or midwife if they could guide you to push slowly while baby is crowning. You could ask that they use warm compresses to help ease baby’s head out during delivery and you could try choosing a position to deliver in that makes it easier for you to direct your own pushing.
Have you given birth before and have some wisdom to add? Did you tear and live to tell the tale? 😉 I’d love to hear from you in the comments and stay tuned for my follow-up with tips for recovering from tearing or cuts during birth.
