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Q&A: Tearing during delivery?

How can I avoid tearing during delivery?

Re: How can I avoid tearing during delivery?

The Bump Expert

Sorry, but there’s no surefire way to prevent tears in the skin surrounding your vagina during delivery. (Yes, ouch.) But, some studies do show that regular perineal massage during the final six weeks can reduce your risk. This technique gently stretches the vaginal opening, making it more elastic and better able to fit around baby's noggin.

To perform the massage yourself, wash your hands and lube up your fingers with KY jelly, vegetable oil or vitamin E. Sit on your bed or on the floor with your knees bent and your legs slightly spread. Place your thumbs three to four centimeters inside your vagina, with the pads of your thumbs pressing on the bottom. Use your thumbs to stretch the vaginal opening downward and to the sides, and hold until it stings slightly. Then gently but firmly massage the bottom half of the vagina, and place a thumb inside and pull outward on the lower rim. Repeat twice a day, and feel free to ask your partner for help! Remember, though: Despite some studies that show that women who massage have fewer tears, many OBs believe it helps very little (or not at all).

watch: more about episiotomies

Paula Kashtan

re: Q: Tears During Delivery?

Pushing only when you're told?!? WFT? They DON'T KNOW WHEN YOU SHOULD PUSH!! You should try to be in as upright position as possible. Occasionally take breaks from pushing to give it a little time to stretch and only push when YOU feel the need to. I ignored the nurse telling me to push and did it the way I felt was right and I have no tears.If OBs think this helps very little, why was the OB that was overseeing the residents that were in the room when I was giving birth doing this to help me stretch?

jennisgreat |

re: Q: Tears During Delivery?

Forgot to mention that I did the perineal massage for 5 weeks. I found sitting on the can worked best for me while I was doing it.

jennisgreat |

re: Q: Tears During Delivery?

Yeah, I'm with the above poster- everything I've read says that you should push when you feel the urge and not when your doctor tells you to. Pushing on command is even discouraged by a friend of mine, who is a labour and delivery nurse.

annabelle.27 |

re: Q: Tears during delivery?

I also agree with pp's. The 'purple pushing' method is BAD - nurses, doctors, even your own mother cannot tell you when to push because they cannot FEEL your body and feel what it's telling YOU. Only YOU can listen to your body and it will tell you when to push - it's called 'spontaneous pushing' - you listen to your own body's signals and it will actually eventually even push for you - like a spontaneous, involuntary push. Weird analogy, but it's like when you throw up - you can't control it, your body does. It's like throwing up except your body is throwing 'down' to push the baby out. And no nurse or doctor can really tell when that is happening. AND.. doing this is the best way you can help 'prevent' tearing - letting your body do the work when it needs to instead of being told by someone else.

jholtzman |

re: Q: Tears during delivery?

but if you push too soon you can rupture your cervix - I know someone that happened to

Cytina |

re: Q: Tears during delivery?

I watched my friend deliever and she had no tears but she STOPPED when the midwife said to. I think that is the important part but sorry ladies they can see what is going on down there and there is a point when you need to STOP pushing so you don't tear. I agree 100% to NOT push if you dont feel the need to push.

firsttimemomMT |

re: Q: Tears during delivery?

Every woman is different and a few of my friends who did not have any medication could not feel the urge to push at all, were totally confused and told me that being guided through it was critical. They did not tear at all incidentally.

Sugarpot |

re: Q: Tears during delivery?

Meh. If I tear, I tear. I don't think I'll have time to give myself a vagina massage for the next 5 weeks lol

BuddhaKitty |

Q&A: Tearing during delivery?

I'm actually wondering if putting some lubricant on the opening of the vagina during labor might ease the process of getting the baby's head through - shouldn't it reduce the burning and friction and reduce likelihood of tearing?

lenuka2007 |

Q&A: Tearing during delivery?

My midwife is having me bring an new bottle of olive oil to the delivery and she will use it to message the around my vagina while the baby's head is crowing. This helps moisturize, stretch, and lubricate like you mention.

julieb00lie |

Q&A: Tearing during delivery?

I tore but it wasn't due to pushing, it was due to my beautiful daughter sticking her arm through with her head. My OB tried to get me to stop the push so she could help but at that point I couldn't stop the push and I tore. I'm sore but it's nothing too miserable. My OB recommends witch hazel but I haven't been able to locate it in my local stores, I'll probably go one town over and look, cause it would be nice to heal a lil quicker if that's possible. BTW, if you do tear, try to do whatever you can to keep your bowel movements as soft as possible. I wasn't paying attention after delivery (too busy with the baby) to remember that the epidural and pain meds constipate and I've been playing Colace catch up ever since.

cettafire |

Q&A: Tearing during delivery?

Has anyone heard of Epi-No? It's a product made in Germany to episiotomy or perineal tear from natural birth. http://www.avoidepisiotomy.com/ Both my doctor and the trainer for our childbirth prep class recommended it. It's not available in US. You can buy from an online pharmacy in Austrlia. I think it took about 1-2 weeks for shipping. http://epharmacy.com.au/product.asp?id=47723&pname=EPI%2DNO+Delphine+Plus+Birth+and+Postnatal+Trainer+Device I tried the manual perineal massage and it was a little uncomfortable with my DH's help. Have been trying this for a few days now and you can progress daily by increasing the size. Don't know if it'll help at the end, but doesn't hurt to try. I also notice my urinary incontinence has been cured. Not sure if it was a result of using Epi-No, but I haven't had any accidents since I started using it. I was very hesistant to buy this in the beginning due to cost and since they don't sell in U.S., but my DH convinced me to. I'm really glad I got it now. It's easy to use, not as painful as manual perineal massage, you can increase the size of the balloon to help you stretch, and it's cured my urinary incontinence.

susu1105 |

Q&A: Tearing during delivery?

I just wanted ladies to know that sometimes it can't be prevented. With my first delivery, I deliverd an 8lb 13oz boy who wanted his arm folded when he wanted to bring it out. I was delivering his shoulders and an arm at the same time! Despite all the messaging my midwives did, I still tore. They probably would have given me and episiotomy, but I actually asked to not have one, and to just tear if it was going to happen. You tent to tear at the weakest point in your muscle, causing the stronger parts to still be in tact. I was a little sore, but probably no more than usual. The massage may have prevented me from tearing all the way to my rectum though, so I would suggest it, atleast during delivery.

taffie |

Q&A: Tearing during delivery?

I found that once my push contractions started, there was nothing I could do to control it. My body took over. Both my births were unmedicated, however. I imagine it's a lot harder to work with your body if you're numb from the waist down, so you would have to do whatever the staff was telling you. As for tearing/ episiotomy, it sounds awful, but I didn't even feel it with everything else going on. The stitches hurt a bit going in but at that point you've got a lot of adrenaline going to take the edge off and a new baby to distract you.

titania9 |

Q&A: Tearing during delivery?

The reason women should listen to the advice of the doctor or midwife regarding pushing, is because they can actually see what is going on down there. If you feel the need to push and they say not to, it's probably because it looks like you're going to tear or maybe the cord is around the baby's neck and they need to remove it, etc. That said, if they say to push and you don't feel the urge, then don't.

jen_jupiter |

Q&A: Tearing during delivery?

Your uterus does about 80% of the pushing for you, your actual pushes just make the process go faster. If your OB is good they will know when to tell you to push if you have meds and can't feel when to push. That is why they have that machine to know when your contractions are happening. You OB should also know when an episiotamy is necissary.

vbraun |

Q&A: Tearing during delivery?

My best friend just had a baby and felt the same as everyone here seems to... Don't push if you don't feel the need. Unfortunately she didn't realize that her baby was suddenly showing signs of distress and the doctor was trying to get her out as quickly as possible, so my friend fought the doctor and wouldn't push when told. Her baby now has complications. Pushing when you don't feel the urge isn't always a bad thing. Sometimes the doctor really does know best. Maybe he should have kept her more informed, but at that point she was in such a state of pain I don't know that frightening her with the news of her baby in distress would have helped the matter any. He did what he had to do to deliver the baby alive and keep the mother (who was med free) as calm as possible. I'm now due in 2 1/2 weeks. I plan to push when I feel the need, but if my doctor suddenly starts telling me when to push I'm going to. I would rather tear and deliver a healthy baby, then chance the alternative.

CMann696 |

Q&A: Tearing during delivery?

i don't agree with pushing when you feel the urge. listen to the doctor. if you push at the wrong time it can damage the babys head. i'm pretty sure the doctor knows best.

sharnirosee |

Q&A: Tearing during delivery?

How can you even reach to give yourself the massage!! There is no way I can get my hands in there...

jacquelinechantelle |

Q&A: Tearing during delivery?

I agree with Jaquelinecchantel!! lol.....I don't think I can make that stretch either! hahaha

kmcmullan |

Q&A: Tearing during delivery?

LOL Jaquelinechantelle! Sitting here reading all of these posts, I swear I was thinking the same thing! Glad to have come across your's...because that is not even a possibility for me either.

avien |

Q&A: Tearing during delivery?

You guys can't reach your vaginas? Are you all T-Rex's? I'm hugely overweight, and I can reach both my vagina and my anus just fine. In fact, about the only part of my body I can't reach is right between my shoulder blades, and that's true whether I'm pregnant or not.

littleplum |

Q&A: Tearing during delivery?

i only gained 25 lbs and i'm at 37 weeks now and I have an extremely difficult time reaching my vagina for the massage. someone mentioned sitting on the floor with ur knees bent and legs apart, i'll try that and hope for the best. i thought sitting on the toilet would provide me good access but it was still really difficult.

shezadibaig |

Q&A: Tearing during delivery?

I tore horribly when my son was born and I have no idea why!! granted, his head was 14.5 inches, but I feel like my OB should have done a better job of not letting me tear?? thats what my mom tells me anyways. I would love to know how to prevent it from happening again, as the recovery was BRUTAL. do what you can, ladies, to prevent it. Its not fun.

Lilredmama |

Q&A: Tearing during delivery?

I had an episiotomy and then I tore on top of that! It was bad, but I didn't do any kind of massage before delivering. My midwife did while the baby was crowning, but it didn't do much good. This time around I'm having a water birth and supposedly I shouldn't tear at all, but I'm going to try the massage anyway!

Lady713Luck |

Q&A: Tearing during delivery?

To the ladies who can't reach their vaginas..how are you washing it if you can't reach it?

tahtil |

Q&A: Tearing during delivery?

I'm not big but have gained 38lbs this pregnancy when before I weighed 142. Well, I am almost 39 weeks and I find it hard sometimes to wipe properly after using the bathroom. Reason being...the baby may be in one of his/her positions which make it difficult.Not all the time but most of time, now! I have a one of them sponge brushes, you know the ones you use to reach your back, for sanitary reasons for down there for when I shower. lol...Plus keeping wipes above the toilet helps as well as keeping a fresh pad after every time you use the bathroom. But still, I soak in a bath at night & take a shower in the mornings.

Truly Blessed with 2 |

Q&A: Tearing during delivery?

A few things to consider: 1. An episiotomy is actually MORE likely to make you tear and/or make your tear worse. Think of it as a t-shirt. Your vagina is stretchy anyway (like a t-shirt). If you pull and tug at the neck of the shirt, it will take a LOT of force to tear it; however, if you cut it to "prevent worse tears," you'll actually make it easier to tear and generally cause the tears to stretch into the muscles underneath as well as further back (into the anal area). 2. Spontaneous pushing, aka mother-directed pushing, is the best way to prevent tears and issues with a swollen cervix. If your nose is congested, do you wait for a doctor to tell you to blow it? Of course not. You can feel when it needs to be blown. You can use the contractions to their full potential if you are in control of what you are doing. To temper this, though, obviously some of you ladies have stated specific concerns regarding a sudden desperate need to listen to the doctor. It is a really good idea to make sure that your birth partner is able to communicate for you. The doctor is not a god. He/she is rendering a service to you. Therefore, they owe it to you to explain what is happening and why. If you are incapable of conversation (which you likely will be at that point), your birth partner needs to be your advocate. 3. Perineal massage is generally considered to not help. It has only entered mainstream medicine in the past 20 or so years. Tears have not been reduced by any appreciable amount. Although if you want to try it, there's no evidence against it (with the exception of possible UTIs if you're susceptible and if you/your helper hasn't washed up prior to attempting the massage).

hodonne3 |

Q&A: Tearing during delivery?

I tore all three times with my babies (delivered all natural). Im 37 weeks today and I'm not going to worry about massage anything. If it tears, it tears. lol. My last baby was born at a birthing center in the jacuzzi and my midwife told me not to push AT ALL just let the baby ease on out. YA RIGHT!! I just had the urge to push even when I tried to HOLD IT...ya right. She said if i push I'm putting a lot of pressure/ force and I will tear. I tried my best not to push but again MY BODY JUST DID IT ON ITS OWN. Your body is in control at that point and there's nothing you can do. Yes there comes a time when you need to listen to the doctor but that 1,2,3,-10 pushing is kind of weird to me. I still tore; maybe because of the previous tears so I'm thin down there. IDK. The midwife did numb me when she stitched me up but it wasnt that bad guys. If I wipe sometimes I tear my own skin down there so I KNOW tearing is in future for me. DONT WORRY OR STRESS ABOUT IT LADIES.....its allll good :)

sngregory79 |

Q&A: Tearing during delivery?

My second baby was a natural VBAC with a midwife and I did perineal massage but I still ended up with a 4th degree tear (which is the most severe). My baby was 7lbs 5 oz. All that stuff about the baby's head numbing the perineum is a lie, I felt every rip and it was much worse than the strongest contractions. They numbed me up before stitches but by that point I had my baby and it was such a relief that I didn't care about the needle for numbing or the tear. Whether you tear or need an episiotomy and even if you don't tear, you're gonna be uncomfortable down there after the birth. Don't fixate on the tearing, if it happens it happens. Soaking in a warm tub with epsom salts after the birth feels wonderful (and who wouldn't want a soak in a tub after all that hard work). I'm choosing the natural route again this time and there are good chances I will tear again as scar tissue doesn't stretch very well, but worrying about it isn't going to change it.

Kushies |

Q&A: Tearing during delivery?

I've heard that the hands-and-knees position can be a great one when it comes to preventing tears, since it takes the pressure off the perineum; it's also a good position for larger babies and has been used in cases of shoulder dystocia to successfully avoid a c-section.

gy86 |

Q&A: Tearing during delivery?

I'm sitting here reading this thread and cringing in phantom vag pain. I have three and a half months left before d-day and I already get the dry heaves just thinking about it. No going back now!

snowgirl0429 |

Q&A: Tearing during delivery?

ok i understand what your saying but take into consideration if you had an epidural. I had one with my daughter, and will have one with this baby. i had no idea when i was even having a contraction with out looking at the monitor or listening to the nurse because i couldnt feel nothing. i had no urge to push because there was no feeling. That is why you need to listen to the dr and nurse

jcarlisle8790 |

Q&A: Tearing during delivery?

Massage perineum with your thumbs.............wow I wish I could reach!

Mregula |

Q&A: Tearing during delivery?

I tore for both my 2 boys ! Having a girl in 3 weeks, and I don't Even want to chance tearing again. It was 8 months of recovery last time Delivering a 9 lb baby was not something I should have done. So a c - section is scheduled this time. They said its hard to repair those Muscles again. So if you have torn a few times ask about a c- section. You really don't want to have trouble down the road.

Ktulo |

Q&A: Tearing during delivery?

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watson012 |

Q&A: Tearing during delivery?

As far as tearing goes, I will say that our birthing instructor told us that tearing is much more healthy than an episiotomy. Alot of times with an episiotomy you have a much larger tear than if your body did it naturally because once u start a tear it is easier for it to continue on. Labor is stressful enough. you really really shouldn't worry yourself about things that you cannot change. It may happen; it may not. everyone is different.

jusjen77 |

Q&A: Tearing during delivery?

I was tore horribly and got Rectovaginal Fistula. Look it up, its horrible. I pray no one else goes through this.. So if this massage is best then def do it!

MarineWife2 |

Q&A: Tearing during delivery?

I had a third degree tear. My son was 7 pounds and his head came out fine, but it was his shoulder that caused the tear. The first few days were excruciating, but its gotten phenomenonally better. To help with BMs, my doctor is having me take Dulcolax (the pill, not the suppository!)

joeysmama0201 |

Q&A: Tearing during delivery?

Oh god littleplum your post just made me laugh so hard I almost pissed myself. But that probably has to do with my baby's head pushing on my bladder.......cheers!

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Q&A: Tearing during delivery?

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emoboy |

Q&A: Tearing during delivery?

I have a replay to littleplum's message but first I will copy her message so I can reply below: You guys can't reach your vaginas? Are you all T-Rex's? I'm hugely overweight, and I can reach both my vagina and my anus just fine. In fact, about the only part of my body I can't reach is right between my shoulder blades, and that's true whether I'm pregnant or not. littleplum | February 23 , 2011 5:28 PM My Reply: I am not overweight nor was I before pregnancy and I believe that is why I cannot hardly reach. My belly is hard as a rock. I have no room to move. You say that you were overweight and you were able to reach just fine, but It may be because you had some more maneuverability from being overweight. I on the other hand have a very limited ability to move around much. My skin is pulling and my belly is so hard, I have to really stretch to wipe after using the restroom. TMI (I know). But I just wanted to let you know that it really is hard for some of us to reach....and it has nothing to do with little arms! :)

Drea0223 |

tearing-during-delivery

I just came across several short videos of über midwife Ina May Gaskin talking about birth and what she calls, the sphincter law. This is basically the idea that the sphincter only opens when you feel safe and relaxed. (And this does not include the situation wherein someone is leaning over you telling you to “Relax!”.) she said: kissing can prevent tearing!! see www.originalmama.wordpress.com for the whole article and video links.... Anneke

DutchYogini |

Q&A: Tearing during delivery?

I tore during both of my deliveries. I chose to allow tearing instead of having an episiotomy. I knew that was my birth plan so I prepared for the possibility of a tear. I had several short deep tears with my first child and several shallow ones with my second, who was a 9 pound baby. I got on a website and found a recipe for an all natural healing spray after birth. I made it and used it after both babies. I healed so well I have decided to sell it on Etsy because its amazing. I used the spray after every time I went to the bathroom and I was healed in days. I also took epsom salt baths several times a day to assist with healing. You can find the spray at http://www.etsy.com/shop/itfeelssogood. If you can't afford the spray just convo me and I am happy to give you the recipe.

itfeelssogood |

Q&A: Tearing during delivery?

RE: pushing only when you're told--I think this phrase can mean 2 things and often gets misunderstood. You should push with your body, not just because you are told. But I had the urge to push before I was fully dilated. I could have really injured myself or my son if I'd pushed then. Wait until your doctor/midwife says okay, but then push when your body says rather than having them tell you for every push.

KimBEARly |

Q&A: Tearing during delivery?

My midwife explained this perfectly to me: There are 4 basic elements that influence your risk of tearing. The first is your skin. If you have prominent stretch marks or really dry skin, you are more prone to tearing. Using a natural oil like olive or mineral oil to lubricate the area during massage or during labor can help. Secondly, your position. Lying in a hospital bed with your feet in stirrups greatly increases your chance of tearing. Standing/squatting or hands and knees are best to reduce tearing. Thirdly, if you are given any analgesia that inhibits you from feeling your vagina, you are at higher risk of tearing. Think about it: our bodies naturally avoid injury. If you are numb, you inhibit that pathway and will punch the baby out, overriding our natural safety mechanisms to limit injury. Also, if you have any medications or interventions that speed up labor you risk tearing. Finally, most OBs want to get you in and out as quickly as possible (they have tee times!) and will tell you to push before you really need to or before your body is ready. If you don't give your body time to fully stretch, you will tear. Also, NEVER get an episiotomy!!! EVER! You risk 3rd and 4th degree tears which are absolutely horrific.

laurenmdrn16 |