How Do I Avoid Perineal Tearing?

 

The thought of a perineal or vaginal tear is, well, tearifying.

Your vagina is required to stretch significantly to accommodate your baby’s birth. And while your body is designed to stretch in this way, that doesn’t always mean you’ll escape the experience laceration-free.

So How Can I Prevent Tearing During Childbirth?

 

While nothing is foolproof, there are some strategies that have proven useful in reducing your risk, including:

·       Perineal massage. Some studies have shown that when giving birth vaginally for the first time, the risk of lacerations was reduced when perineal massage was used. Other studies have shown that perineal massage is not helpful, and may make tearing worse. Talk to your primary care provider about whether perineal massage is right for you, and how to do it safel. 

·       Different positions for pushing. You can try pushing on your side, on all fours, or squatting. Your doula or partner can help you get repositioned. Listen to your body and do what feels most comfortable for you. If something isn’t working, change it up.

·       Professional guidance during crowning. You may be asked by your primary care provider to pant or breathe deeply without pushing for a few moments, giving your perineum time to stretch more effectively. Follow these instructions to help ease your body through childbirth. One trick is to think about blowing like you are trying to keep a feather in the air; a sustained and upwards breath.

·       Warm compresses. Not only can warm compresses be very soothing, using them as the time to push gets closer will help relax your perineum.

 

Perineal tears happen as your baby’s head is being birthed. Most perineal trauma is considered superficial and either requires no treatment or minimal stitching. Should you require stitches the area will be numbed. If all is well with you and your baby, you’ll be busy snuggling your little one while your primary care provider repairs the area.

After birth your bottom will likely be sore, regardless of whether you have stitches or lacerations. You can ease your discomfort by using a perineal bottle (squirt bottles generally supplied by your hospital or midwife) to rinse your vulva while you pee. Rinse the area again after you’re done, and pat gently dry with tissue. You may find ice packs  comforting or, if it feels better, a warm compress.

There are several commercial products available to lessen discomfort as well.  They include numbing sprays, perineum healing sprays, or perineal spray of your choice) and herbal combinations for sitz baths. Talk to your primary care provider about what may work to speed up your own recovery.

If you’re feeling fearful about how perineal tearing may affect your postpartum recovery, talk to your doula or primary care provider. With a little planning for birth and post-birth care, you’ll feel more confident about the process.  Plus, being prepared will help get you back to feeling like yourself faster.  In this case, having more information is a win!