There are several factors that can help you avoid tearing during childbirth. Use these tips to have a safer, healthier 2nd stage of labor.
- CHOOSE A MIDWIFE
The first one is, choose a midwife to be your care provider and your birth attendant. Studies show that Midwives, are less likely to use forceps and vacuum extractors, which are instruments that assist with pulling a baby out at birth. Midwives are less likely to perform an episiotomy which is a surgical incision to make the vaginal opening larger. Bottom line: The midwife model of care leads to fewer interventions. Using these 2nd stage interventions can greatly increase your risks of tearing.
- CHOOSE A COMPREHENSIVE CHILDBIRTH CLASS (live, virtual, or in-person)
What if you are unable to have a midwife attend your birth? Make sure you take a good comprehensive childbirth class that covers:
- Natural breathing combined with relaxation techniques
- Comfort Measures
- The risks and benefits to medical procedures and interventions and alternatives
- Informed Consent Questions so that you can make decisions with your care provider
- Positions to use during labor and birth
- The normal physiology of labor and birth
Taking a childbirth class will reduce your levels of anxiety and give you the confidence and courage to handle your labor and birth the way you want to. Check out my Bradley Method Schedule here.
- YOUR NUTRITION CAN AFFECT YOUR BIRTH OUTCOME
Eating a good, nutritious, pregnancy diet is key to having a healthy pregnancy, baby, and birth. Your body will be able to perform optimally. Your skin will be healthy and less likely to tear. It’s like preparing for a marathon. You must stay focused on the goal. If you were preparing for a marathon, you’d practice running daily, eat right, etc. It’s the same with pregnancy and birth. Eat:
- 80-100 grams pf protein daily
- Salt your food to taste
- Drink half your numeric body weight in water daily
- Consume 2400-2600 calories/day including a wide range of vegetables, fruits, nuts, legumes, meats, fish, etc.
- PRACTICE DAILY EXERCISES TO HELP POSITION YOUR BABY
Another factor that can increase tearing during childbirth is the position of your baby. If your baby is occiput posterior, you are more likely to tear. So, what can you do during pregnancy to try to avoid a posterior baby? You can practice, daily:
- Pelvic rocking,
- The Spinning Babies’ Forward Leaning Inversion,
- Resting on your left side (watching TV, napping), and
- Sitting (at your desk, in the car) with your knees lower than your hips and pelvis slightly tilted forward in its natural position (good posture).
- Prenatal Yoga
- SEE MY PRENATAL YOGA VIDEOS ON YOGADOWNLOAD
- DON’T TAKE THIS LYING DOWN
Speaking of positions, the position in which you choose to push can lower your risks of tearing. If you choose to get an epidural you will limit your positions choices and increase your risks of tearing. You won’t be able to change positions:
- Lying on your side instead of on your back (most common for women in hospitals and possible with an epidural)
- Any upright position that takes advantage of gravity like squatting, standing, sitting on a birth stool, or sitting on the toilet.
- Hands and knees position
- Waterbirth helps relieve pain and lubricates the skin while stretching.
6. COMMUNICATE WITH YOUR CARE PROVIDER
Ask your care provider to use warm compresses and lubricant/oil to massage the perineum while you push can help the skin to stretch and avoid tears. Educate yourself about natural childbirth and make that your goal. Choosing a supportive care provider, and hiring a doula can help. Ask them how they can help you to have a vaginal birth and avoid a Cesarean.
- LEARN COMFORT MEASURES AND RELAXATION TECHNIQUES
Epidural anesthesia can increase your risks of tearing during childbirth. One study* stated, “Epidural analgesia is associated with an increase in severe perineal trauma as a result of an associated threefold increased risk of instrument use. Instruments used in vaginal delivery more than triples the risk of severe perineal laceration.”
Epidurals increase the length of 2nd stage because your muscles are compromised by the medication. Your muscles are less effective in rotating your baby into a good position for the descent.
- LEARN INSTINCTIVE PUSHING AND PRACTICE POSITIONS
Learn to use instinctive pushing, also known as spontaneous pushing, instead of directed pushing ( a good childbirth class will teach you this). Instinctive pushing relies on the mother’s instincts. She can hold her breath as a form of pain control, and add pressure to the top of the uterus. This helps the uterus push the baby out. Mothers can push 3-5 times per contraction. This is less stressful on the baby and ensures oxygen to the baby and more effective pushes.
Epidural Analgesia and Severe Perineal Laceration in a Community-based Obstetric Practice: https://www.medscape.com/viewarticle/449423
Best practices in second stage labor care: maternal bearing down and positioning: ttps://pubmed.ncbi.nlm.nih.gov/17467590/
What’s the evidence for perineal massage during pregnancy?https://www.lamaze.org/Connecting-the-Dots/what-is-the-evidence-for-perineal-massage-during-pregnancy-to-prevent-tearing