A common concern with birth is tearing! We all would like to prevent or minimize tearing while giving birth to our babies. Some folks think tearing is inevitable, but there are some things we can do to help minimize or avoid tearing!
If you do tear, however, know it’s not your fault! There is a lot we can do to support healing from a vaginal tear.
Let’s discuss three ways to prevent tearing during birth!
Pushing: Avoid Tearing During Birth
Vaginal tears can be common during birth! But, there are many things we can do to minimize the severity or avoid it altogether!
Typically, subsequent births have a lower risk or lesser degree of tearing, with the first time you’ve had a vaginal birth having the highest risk of tearing.
In my experience, how your provider manages your baby’s delivery can influence if you tear or not, so keeping some of these tips in mind can help prevent tearing!
Learn more pushing techniques and approaches in our online childbirth education course.
3 Tips to Prevent Tearing
There are a lot of things we can do to prevent or minimize tearing, but let’s discuss three main ones:
- Slow the push while crowning
- Relax the legs
- Guide baby’s head out with your hand
These three things tend to be something you can do with or without your provider’s guidance but may be harder to remember at the moment if someone else is yelling or encouraging you to push hard or spread your knees super wide.
We discuss more pushing techniques such as how to breathe while pushing, pushing positions, and how to approach pushing in our childbirth education courses!
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1) Slow the Final Push!
The first way to minimize tearing is to SLOW the final push when baby is crowning.
As baby’s head begins to crown, we want to transition from longer, harder pushes to short, easy pushes.
Ways to do this is to transition from either holding your breath or exhaling down, to puffs, pants, or short blows of air.
Baby is coming no matter what, so small, short pushes will ease them out, allowing them to stretch the perineal tissues slowly.
This may be hard to remember to do if your support team is yelling or encouraging you to push hard as your baby is crowning. So, it can be helpful if your partner or doula reminds you to slow down while crowning to ease your baby out.
2) Relax the Legs!
Next, we can release the tension in the perineal tissues by relaxing the legs.
We may be encouraged to spread the knees super wide, especially during crowning, because it makes it easier for the provider to see what’s going on with your baby’s birth.
But, spreading the knees super wide closes the pelvic outlet (which may slow pushing efforts), and also it stretches the perineal tissues.
There is only so much stretch that tissues can have before they will tear, so if we are stretching our perineal tissues AND THEN adding baby’s head stretch to the perineum, we will likely see some tearing.
So, bring the knees closer together. RELAX the legs as much as you can; so avoid pulling your legs close to your chest.
This will help to release the tension in the perineum and allow baby’s head to stretch it without resistance.
3) Guide Baby's Head with Your Hand!
And finally, you can guide your baby’s head out with your hand! You can feel baby’s head as they begin to crown, and this can help motivate you to slow down.
Your provider may want you to move your hand as baby is being born to help support their head and shoulder delivery, but you can definitely reach down to feel their head as they crown to motivate you to ease them out.
But what if you still have a vaginal tear??
Sometimes tearing is inevitable and is not your fault! Baby’s position can influence a tear, such as if they have an elbow or hand up by their face, or if they are slightly misaligned. Or maybe you needed some assistance while pushing, such as a vacuum or forceps, and it caused a tear.
Fortunately, there is a lot we can do to support vaginal tear healing! Keeping the tear clean by using a peribottle and sprays or salves tends to be a go-to. And then seeing a pelvic floor physical therapist to do scar mobilization after you’ve been cleared is a great way to support pelvic floor healing after a vaginal tear!
In future pregnancies and births, you may want to consider doing scar mobilization during pregnancy to release any adhesions in the pelvic floor and perineal tissues to minimize tearing in your subsequent birth!
Tearing is not always inevitable!
We can do a lot to minimize or alleviate tearing during birth!
We can adjust how we push and breathe to slow down crowning, allowing the baby to ease out and stretch the perineal tissues slowly.
We can relax the legs to release the tension in the perineum. And we can guide our baby’s head out with our hands to motivate us to slow down!
If we do have a tear, it’s okay! We can manage wound healing and see a pelvic floor physical therapist to optimize our scar and pelvic floor healing for overall function and future births!
This course explore your pelvic floor anatomy, function, and how to prepare your pelvic floor for birth! This course includes educational videos, mobility exercises, relaxation drills, and how to relax your pelvic floor during labor tips.
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