Pregnancy and you blog

Tearing during childbirth: Can you prevent it?

By Mary M. Murry, R.N., C.N.M. November 8, 2013

We gather many souvenirs from childbirth. Some, like your new baby, are wonderful. Others, such as a sore bottom, are not. For some women, it goes beyond just a sore bottom. If you have extensive vaginal tearing or an incision made in your perineum (episiotomy), the healing process can feel like hell on earth.

Whether you're about to deliver for the first time or you're pregnant again, you might wonder: Is there anything you can do to help prevent tearing during childbirth? I believe there is. For example:

  • Stay healthy. Eat a balanced diet and take your prenatal vitamins. This can help keep your skin and other tissues healthy. Exercise frequently and do Kegel exercises to build your strength. Practice conscious relaxation or meditation. This can help reduce stress.
  • Prepare to push. You want the second stage of labor, the pushing stage, to go slower than you might expect. Pushing the baby out gently and slowly can allow your tissue time to stretch and give way for the baby. Instead of taking a deep breath, holding it and pushing, try exhale pushing. During exhale pushing you slowly breathe in and slowly exhale, perhaps making a low or deep sound as you push. When the baby starts to crown, you might switch to using short — almost grunting — pushes.
  • Use a lubricant. Applying a lubricant, such as warmed mineral oil, can decrease friction and help the baby slide out. In my opinion, there is no such thing as too much oil.
  • Keep your perineum warm. Placing a warm cloth on your perineum increases the blood flow and softens the muscles. If possible, you could also get into a tub of warm water during active labor. If you've never given birth vaginally, you also might benefit from perineal massage.
  • Push and deliver on your side. This can also help decrease any excessive perineal stretching.

Discuss the topic with your health care provider, too. Does your provider use these strategies? Does the labor and delivery staff support the use of these alternatives for slowing your baby's delivery? Do you need to bring your own oil or is oil available? Is everyone involved comfortable with alternative childbirth positions? Knowing the answers to these questions can further help you prepare or make alternative plans.

Of course, there is no fool-proof method to ensure you won't need stitches or repair after childbirth. But having a plan and feeling empowered to follow it might make this souvenir a little less memorable.

Nov. 08, 2013