This is what we want to know…how can I avoid tears during delivery!!?? First, it is important to recognize that vaginal tearing is quite normal and happens fairly often especially if it is your first baby as the tissue is less flexible. The good news is, typically after your first vaginal delivery the tissue is more flexible so tearing becomes less likely for future babies.
There is no guarantee you will be able to prevent tearing during childbirth, but research suggests that there are ways we can allow the perineum to stretch and help reduce the risk for tears.
Perineal stretching and massage are one of these ways!
Perineal massage is the gentle manual stretching of the skin between your vagina and rectum to prepare the muscles and skin to stretch during the birth of your baby. If the perineum is more flexible to stretch then the risk of tearing and stitches is lower. It is thought that perineal massage should then lead to less perineal pain after delivery as well.
Recommendations for perineal massage seem to be starting the technique at 34ish weeks, taking about 5 minutes, and performed at least 2 times per week.
For more information on perineal massage, you could ask your health care provider or reach out to a physiotherapist as they are so knowledgeable in the pelvic floor area!
To reduce the risk for perineal tearing try to get into a labour position that puts less pressure on your vaginal floor. Some of these positions include squatting, side-lying, hands, and knees, or other forward-leaning positions. These positions not only take some pressure off the perineum but also creates more space within your pelvis to help the baby come down.
The delivery may be the key moment to really help reduce the risk for tears. Your health care provider will be present when it is time to deliver your baby. Up until your baby is born, health care providers will often apply some warm compresses to the perineum and will sometimes massage the perineum to help it stretch while you are pushing.
During delivery, aim for more controlled pushing. Your healthcare provider will offer you guidance here but they are looking for you to change your pushes from those nice strong pushes you have been used to doing during the pushing stage to slow short controlled pushes as your baby’s head is delivering. Pushing the baby out gently and slowly can allow your tissue time to stretch, basically easing the baby out and reducing the risk of tissue tearing. Your health care provider may apply a little counter-pressure on the baby’s head during delivery to again help slow and control the speed of your baby’s head coming out.
If you want more information on labour and delivery consider reaching out to the Mama Coach in your area and booking a prenatal class! We cover pushing and tears but also so much more!!