Avoiding Vaginal tearing - tips

Jayneypops

Mum to 2 Fairy Princesses
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Hi Ladies,

I am planning a water birth at home to help me remain relaxed during labour, and hopefully make the whole process less traumatic to my body (this is my first).
I have been doing a bit of research on pelvic floor damage and vaginal/perineum tearing and have read some interesting tips and wondered if anyone has successfully used these tips - or has any other pearls of wisdom!

Tips to prevent tearing:

1. Perineal Massage - Especially effective in first time mothers as the skin of the vagina and perineum os tight and not as flexible as mothers who have given birth before. Massage is recommended in the final 6 weeks of pregnancy and can be done with any natural oil (Olive Oil for example). The Perineum is the area of skin between the vagina and anus. Just massaging this once per day for a few minutes can help improve blood flow which will improve elasticity.
2. Labour Down - This is basically a technique which avoids prolonged periods of pushing. Prolonged pushing puts too much pressure on the perineum so the advice is to wait until you are fully dilated, then rather than begin pushing, wait 1 hour to give blood the chance to flow to the vagina and allow you body to begin its own natural gentle pushing moving the baby downwards.
3. Avoid assisted birth if possible - The use of forceps or vacuum can cause the baby to be crowned and passed through the vagina more rapidly than the skin is ready for. Obviously in an emergency this cannot be avoided but if possible ask your midwife to use forceps/vacuum to the point of crowning and then wait a while for the babys head to stretch the skin before the shoulders pass through.
4. Avoid pushing whilst the head is crowning - Ask your Midwife to help you to stop pushing, even when the urge is intense, once the babys head crowns. If you can wait a few minutes, before gently pushing again, the baby will begin to naturally move downwards at a more relaxed rate. Making the process easier on your skin.
5. Do your Pelvic Floor exercises - Not only do these help prevent incontinence during and after pregnancy, but the stronger these muscles are, the better they will work during labour/delivery and damage will be less likely. Begin by practising stopping half way through a pee each time you go. This will train you to recognise the pelvic floor muscles (they are the ones you are using to hold the pee!)

Hopefully these will be of use to some of you - I would love to hear others.

As I will be in water, I am assuming the warmth will increase the blood flow to that area and so also help prevent tearing? Is this true?
 
1 - I never bothered with perineal massage. I can't see how it can do any harm, but it can be difficult to do in late pregnancy and I honestly don't think it necessary. Your vag. is well primed to let a baby through all ready, without massage. I really believe that!!

2 - This is bound to be better than prolonged period of purple pushing but honestly? Don't overthink it. Do what you feel like. If you feel like pushing, TRUST YOURSELF! Don;t wait for a VE and news that "you are a 10" and you have "permission" to push! Sometimes, pushing HELPS you dilate! Sometimes, our baby has a big head and you (wait for it, this is gold) dilate PAST TEN CM! I know I know! 10 is NOT the max. you can dilate to! It's just a number :) So: listen to your body!

These are some GREAT links on pushing!

https://midwifethinking.com/2011/01/22/the-anterior-cervical-lip-how-to-ruin-a-perfectly-good-birth/

https://www.midwiferytoday.com/articles/pushing.asp

https://www.birthologie.com/birth/what-you-dont-know-about-your-cervix/

3 - Honestly? If the birth is assisted, the thing will be: baby is in trouble and needs to come out NOW. :wacko:

4 - I will never believe that a professional will know how to push my baby out better than I do. When you are being sick, can you do it more effectively if somone stands at your shoulder and tells you when to retch and when to try not to retch? YMMV.

5 - https://mamasweat.blogspot.com/2010/05/pelvic-floor-party-kegels-are-not.html <<<SQUAT!

Also - position is important. Lying on your back is not great; it increases your chance of tearing. It also decreases blood flow (oxygen) to your uterus (less effective contractions) and your baby (more likely to go into distress) meaning more chance you will need that asst. delivery! Listen to your body! Move as you feel you need to.... If you must be lying down bc you need help, sidelying is better than on your back :)

Another thing: DIET! More linkage for you :) https://birthfaith.org/nutrition/protecting-your-perineum-from-the-inside-out

HTH :flower:
 
lol once im fully dilated my babies have a habit of moving down and out pretty fast i didnt push with Alister at all my body did everything itself and i tore
 
Things that help to prevent tearing is, birthing at home, being in water, being in a sqauting position so your hips are as open as can be, no vacuum or forceps. Also what helped me was my DH put slight pressure with a cloth of oil on my perineum as I was birthing his head. It felt really nice (no ring of fire) and I had no tearing (I did tear with my frist in the hospital).
 
We did perineal massage religiously for 4weeks for my first (with EPO) and were rewarded with not even a tear for a 9lbs baby! It takes a brave husband though! lOL

Another thing I had for both of my births is a hot wash cloth on the vagina between contractions to soften things! (Felt good, too!)

We are planning on a water birth this time, but if not I will insist on the hot cloth again!
 
I didnt tear with either of my babies despite roman being born with a nuchal hand and them both being back to back. I didnt really do anything special but I did listen to my MW and didnt push when she said not to.
 
Listen to YOURSELF. To your body. It will tell you exactly what to do when. Generally home births are completely unmediated and this means you and your baby can communicate effectively.

This is a nice post about Pushing for Primips
 
Thanks for attaching this post- very useful for a first time mum planning a homebirth.

Listen to YOURSELF. To your body. It will tell you exactly what to do when. Generally home births are completely unmediated and this means you and your baby can communicate effectively.

This is a nice post about Pushing for Primips
 

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