As a doula, one of the most common questions I am asked is how to avoid tearing during birth. It is an understandable question, as the concept of tearing during birth can seem terrifying to just about anyone. In today’s post, I will provide you with 7 different tips to minimize the chances of tearing occurring, so you can know exactly how to prevent tearing during birth.
Avoid Tearing During Birth: Practice Perineal Massage
A perineal massage may not be the same relaxing experience as going to the spa and getting a full body massage, but it is a great tool to use in order to prepare for the sensations of birth. While it is not proven to prevent tearing, it can still be a good preparation tool in order to train the body to relax despite intense feelings.
The goal of a perennial massage is to stretch out the skin surrounding the perineum, and the relax the vaginal wall so that it is more loosened for the pushing stage of birth.
It helps prepare you for the stretching sensation that comes during the final stage of labor, right before the baby’s head comes out. You can practice relaxing your entire body and surrendering to the burning that comes with the stretch so that when you experience a similar stretching in labor, your brain has been wired to embrace its sensations.
How to do Perineal Massage
The first step is to find a relaxing location where you can fully relax your pelvic floor and yourself.
This can be in the bath in a reclined position, or on your bed with your legs in butterfly position. You can do this yourself or use the help of someone else, just make sure either way that hands are squeaky clean.
Then you will begin lightly massaging your perineum with a couple fingers or your thumb and a natural oil, like coconut oil, pressing side to side and in circles, going clockwise and counter clockwise.
When this is done you will put a finger or thumb inside of your vagina and press downward sweeping towards the perineum in the shape of a U. Sweep side to side as well.
Do the right and left sides separately while avoiding hitting the pubic bone. The focus should be on perineal tissues.
You can also stretch and hold specific parts of the tissue that feel tighter and need release. Hold the stretch gently, until you feel the tissue release.
Gradually increase the pressure of the massage, but not to the point where it is painful. Relax and breath through the stretching sensations.
It is recommended to begin doing perennial massage around 35 weeks gestation, 2-3 times per week, for up to 10 minutes, though listen to your body and do it for a shorter length of time if that is what is best.
You can also work up to longer periods of time throughout your sessions.
Perineal massage is an excellent way to avoid tearing during birth and prepare yourself for the process.
Avoid Tearing During Birth: Pelvic Floor Exercises for Strengthening and Relaxing
The pelvic floor is the bowl of muscles and connective tissues that sits at the bottom of the pelvis to provide support for the body. Having a pelvic floor that is both strong but can also relax for both pregnancy and birth is very important to avoid tearing. The structural integrity of the tissues must be strong, but also malleable to the process. This is because strength in the pelvic floor provides a strong control over it during the pushing phase of labor. The relaxation allows for the mother to open up as the baby moves through her pelvis.
The first step is to become familiar with where your pelvic floor actually is. You can do this by sticking your finger in your mouth, and sucking on it like a straw. The sensation you feel working beneath your abdomen is the pelvic floor.
I will note that though kegels are commonly prescribed, this is done so without much consideration to how this exercise actually works. Kegels can actually wreak havoc on the pelvic floor and cause it to be overtighten, which can actually increase the likelihood of tearing during birth. Check out these exercises instead.
More importantly though, go to a pelvic floor therapist BEFORE giving birth. They will be able to see if you need to strengthen or relax the pelvic floor and give you the best exercises possible in order to avoid tearing during birth.
Avoid Tearing During Birth: Do Not Give Birth of your Back
Positioning during the pushing stage of labor is key to preventing tearing. Laying in the lithotomy position actually prevents necessary space from being created for a baby to enter the world. It actually closes the pelvis outlet between 20-30% compared to other birthing positions such as all fours.
It puts more strain on vaginal tissues, as a mother is more so required to work again her body than with the stretching sensations. It can also increase the risk of instrumental delivery via forceps, vacuum, or episiotomy which all are known to result in tearing.
While for some mothers birthing on their backs is preferable, for most it is not an optimal position for the prevention of tearing. Choosing a different pushing position can be a great way to avoid tearing during birth.
Avoid Tearing During Birth: Avoid an Epidural
An epidural increases the likelihood that a mother will need to give birth on their back, and it also increases the likelihood of instrumental delivery or an episiotomy.
The other thing an epidural does is prevent the hormones necessary to induce pushing in the body. This means that a mother cannot work as well with her body to push, which is very important to allow time for stretching in order to avoid tearing during birth.
If you do decide to get an epidural, research positions ahead of time that you can birth in to open the pelvis more so than while on your back. You can also ask that the epidural be turned down during the pushing stage so that you can better feel yourself push in order to avoid tearing during birth.
Avoid Tearing During Birth: Avoid Coached/Purple Pushing and Let your Body Lead
In a physiological birth an instinctive urge to push will occur when a baby’s head makes contact deep in the pelvis. Working with your body’s instinct to push instead of pushing when outside providers tell you to push can be an amazing way to prevent tearing, especially bigger tears like 3rd or 4th degree.
Avoid purple pushing, and instead work with your breath and your own sounding to stretch your baby through your vagina as the perineum stretches open.
Avoid Tearing During Birth: Support the Perineum During the Pushing Stage
You can support your own perineum during the pushing stage through touching your head against it and supporting your baby’s head as it stretches.
You can also ask an assistant to apply warm compresses to your perineum and use the weight of their hands to support the baby’s head as it exits the vagina, in that final stretching stage.
Warm compresses can also increase blood circulation to the area which can help tissues to stretch further. Talk with your provider about how your perineum can be supported in order to avoid tearing during birth.
Avoid Tearing During Birth: Eat a Healthy, Collagen Filled Diet
Our cells are made out of the food that we eat. In other words nutrition is the building block of every structure in our bodies. This includes the tissues surrounding the vaginal opening that can tear during birth. Using food high in amino acids to build of our vaginal tissues can make a big difference in birth and can help a mother to avoid tearing during birth.
My most recommended foods for this would be meat on the bone and bone broth due to the high protein and hyaluronic acid content, which is key to the structure of connective tissues. Consuming meat directly off the bone and bone broth each day is an excellent way to prepare the body to avoid tearing during birth.
Supplementing with collagen can also be an excellent way to build these tissues up nice and strong.
Another recommended food to eat in order to avoid tearing during labor are dates. You can check out my post all about the benefits of consuming dates here.
While these are my top food recommendations, eating a nutrient dense diet filled with fruits, veggies, meat, and organ meats is an incredible way to eat to build up tissue and muscle in the body. Eating a nutrient dense diet can help a mother to avoid tearing during birth. In fact, I recommend that all of my clients consume a nutrient dense diet throughout conception, pregnancy, and postpartum.
You can read all about the principles of a nutrient dense diet here.
Recap
I hope this these tips will be helpful as you move forward in preparing for birth. If you enjoyed it, please save it to Pinterest, or share with a friend!
If you have any more questions, do not hesitate to contact me here.
