If tearing is something you fear, you’re not alone! This is something so many feel apprehensive about. Usually because of what you might have heard – stories from friends, social media, tv.
It’s important for you to know that tearing isn’t a given and doesn’t have to be feared. You can do some things to ease the second ‘pushing’ stage of birth, and there are so many positive birth stories out there for you to feel reassured – birth can be wonderful.
Chances are you’ll sustain a graze the perineum as your baby’s head stretches the delicate perineal skin. And that’s okay! That’s normal, and it should heal perfectly fine. What you are able to try to prevent, is tears which disturb the muscle of the perineum, as this can cause issues and slow healing time.
There are lots of factors here, some things that may help are:
1. Active Labour
Encouraging the process using gravity, by taking kneeling or squatting positions and thinking Upright, Forwards and Open. This can open up the pelvis, allowing baby to naturally slip down the birth canal and into the world.
2. Water Birth.
Warm water can help to soften the area in preparation for the stretch. Water birth has so many wonderful benefits. Being in water doesn’t prevent tears completely, but it can help to soften the perineal skin.
3. Support or warmth on the perineum.
Some midwives suggest a warm compress on the perineum to help guide and warm the area as baby descends. You could also apply some pressure yourself if you’re able to reach comfortably and that’s what you naturally want to do.
4. Breathing baby down gently.
This is one of the most important points about preventing tears. The skin is completely capable of stretching to accommodate for baby. It just needs time! Forcing baby out as quickly as possible may cause injuries, as can ‘coached pushing’ by a midwife.
Breathing with your body, allowing the gentle bobbing in and out of babies head, helps prepare the area. Remember to breathe, relax and use your breath to bare down naturally with your body. Baby doesn’t need to be out as quickly as possible, there is a process and allowing that process can really help keep those muscles in tact.
5. Pelvic floor exercises and perineal massage.
Pelvic floor exercises are so helpful in regaining back strength in those all-important muscles after birth, but they also help with birth itself. Learning to let go of the muscles fully when you’ve squeezed is so important, then you can remember that feeling in preparation for making space for baby during birth.
Perineal massage can help to soften and prepare the area by stretching gently with your fingers, using a lubricant. There are studies that suggest this can really help. Don’t put yourself under too much pressure, though, and stop if it hurts at all. The main thing is that you have confidence in your skin, because let’s face it – pregnancy and birth are already incredible enough, of course your body can move and stretch to accommodate baby. And don’t forget baby’s skull moves to accommodate you, too.
6. Staying calm and relaxed.
Relaxing your jaw actually relaxes your pelvis and pelvic muscles, as it’s all connected bio-mechanically. Breathe, relax your shoulders and your jaw. Letting go of any tension allows for more space for baby, letting those muscles move and adapt. Believe in your body and listen to it, it’s designed to do this.
If you do tear, it might be that you don’t even notice at the time of giving birth. Some people describe a burning sensation when baby’s head arrives, and that doesn’t mean you will tear, it’s just the natural stretching as baby enters the world. Using calming breathing techniques, affirmations and birth partners’ support at this point can help calm you down. This part really isn’t for long. And you are completely capable.
If there is some damage, it can be repaired, it will heal, and there are resources out there to help resolve any problems.
As for stitches, rest assured that without epidural they should always be done with a local anaesthetic, which should be tested for accuracy of placement first.
You’ve done an incredible job birthing your baby, and they’re finally here, in your arms! That is a feeling that just can’t be described. ❤