How Not to Tear During Labor: 5 Practical Tips
We hate to be the bearer of bad news but...
there's nothing you can do to guarantee you won't tear.
However- there are a few things you can do to help boost your chances of having a mostly happy vag when all is said and done.
5 Practical Tips for Protecting Your Perineum
1. Pushing Position- During labor, you definitely want to be utilizing upright positions that work with gravity (read more about how movement effects labor). When it comes to pushing, side-lying positions are your best bet as they are shown to have the "highest rate of intact perineum". Ummm... yes, please.
2. Hydrotherapy- Hydrotherapy (aka water birth), the practice of laboring and/or delivering in a tub of warm water, is awesome for many reasons and this is definitely one of them. The warm water helps you relax deeply and leads to higher incidence of intact perineum. Again, sign me up.
Read more: Hospital Water Birth Options in Fort Worth
3. Feel the Burn- I distinctly remember a point in each of my labors when I experienced the overwhelming get-this-baby-out-now urge and I can usually tell when my clients get there, too. It's totally normal but it can be difficult to navigate and the ability to slow down and not push for the fences will help in reducing trauma to your lady bits. By slowing down as baby crowns (when you typically feel a burning sensation) you allow your tissues to stretch and expand, instead of tearing, as baby eases its way out. A good care provider will help talk you through this stage so speak up and let them know when you feel the burn (insert Bernie Sanders joke here, please).
4. Perineal Massage- First time moms, listen up! Evidence tells us that perineal massage helps reduce the risk of tearing in primips (that's you). Starting at about 34-35 weeks, you'll want to spend about 10 minutes each day inserting a finger or two into your vagina and gently apply pressure first downward and then sideways for about 2 minutes each. Lubrication can be helpful here (coconut oil can be a great choice but any lube will do the trick). *Note: You may want to recruit a partner for help; that angle can get a little tricky.
5. Avoid Epidural- Here's the deal with epidural- they carry with them a three-fold increased risk of instrumental delivery and instrumental delivery triples the risk of severe perineal laceration. Ouch!! But remember, all things are tools, including an epidural. Plenty of women with epidurals push out their babies without tearing so, if that's a route you end up traveling (or hell, a route you want to take- we won't judge you, promise), there are some things you can do to minimize your risk. Number one on the list? Choose a provider you trust!