T is for Tearing
When we begin to talk about birth planning, there are are a lot of common fears that come up. One of the most prevalent is the fear of tearing during childbirth. It's only natural to be apprehensive and wonder how in the world baby will actually come out!
A lot of the fears surrounding this seem to be related to deeper fears of pain, pushing, or a big baby. It's important to work through these fears prenatally, do research (take childbirth classes, read, watch birth videos), and plan your birth so that you know what to expect when the time comes and have your decisions in mind.
Here are a few ways that you can greatly decrease your risk of tearing, and create more ease during the pushing stage.
During the 9 months of pregnancy, focus on your health mentally, physically, and emotionally to prepare for the birth of your baby. This means reducing your stress levels, eating healthy, and working out at your comfort level. Prenatal vitamins are important for your baby to get the nutrients they need, but you also need to keep up your energy stores and nutrition for the marathon of birth. Make sure you are staying hydrated and eating whole foods. I talk about prenatal nutrition in this blog post about Gestation Diabetes as well.
Prenatal Yoga is a great practice as it helps you learn how to use your breathing to cope with pain and stress, strengthens your muscles, and helps with posture and whole body alignment. Meditation goes hand in hand with yoga practice, and is an incredibly effective tool for relaxation. If you're interested but shy about trying out a studio, private classes in Hampton Roads are offered with us, too!
It's true that being in an upright position opens your pelvis up by 20-30% more than the standard position laboring on your back, but there are some things to keep in mind during the birth process. Throughout early labor, I personally say do whatever is comfortable. If you want to labor in water, squat, hang, lunge, do whatever you need to! But when the time comes to push, it's better to avoid squatting and birthing in water.
I know, everyone loves the birth tub. I'm all for relaxing in the warm water throughout your entire birth, but if you are concerned about tearing you should know all the factors at hand. Here's some more information from Mother Rising about the squatting position.
The positions that decrease tearing are kneeling, side lying, and on hands and knees. The pelvis is still open, but the perineum isn't stretched as in positions where your legs are farther apart. Many mothers instinctively move to these positions if not directed to do anything else.
Many sources may recommend perineal massage as a way to prep for labor and birth. I disagree with this, as the information is conflicting. It seems to help for first time moms, but at a very, very small percentage. It can't hurt if you do want to try the massage, but the evidence suggests using warm compresses instead.
You can simply run a washcloth under warm water and hold it against the perineum, or if you want a stack of washcloths on hand a small crockpot on the warm setting can be really helpful. Some also like to add a carrier oil to the water like almond, coconut, or olive oil, to help soften the perineum. Midwives will typically also add a couple slices of ginger to the water, to help with swelling.
I also discuss accessing sensuality during childbirth and how that can be an effective tool in this post here. Not only does this help with pain and stress during birth, but it can also help your muscles and tissues relax even further and assist you in the birthing stage. In labor and birth, we could access this by nipple stimulation, self massage, dancing, kissing your partner, or whatever makes you feel in tune with your body.