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!

 

 

What You Need to Know About Your High-Risk Pregnancy

 

Having your pregnancy labelled as high risk can be very scary. You may have questions such as “Does being high risk mean I must give birth by c-section?” or “How will my experience as high risk be different than normal?”

What Is a High-Risk Pregnancy?

A pregnancy will be labelled high risk if the health of the mother and/or the baby is thought to have an increased chance of complications. While these two little words can induce some anxiety, “high risk” is just a way for a primary care provider to ensure their patient gets the special attention and care they need to have a safe pregnancy and birth experience.

Having your pregnancy labelled high risk does not always mean that you will have problems, only that you are at an increased risk of developing complications.

 

 

Why Would My Pregnancy Be Considered High Risk?

Your pregnancy may be considered high risk if you:

  • Have pre-existing or newly-diagnosed health problems, such as:Diabetes, Cancer, High Blood Pressure, Kidney Disease, Epilepsy, HIV, Hepatitis C, Rubella, Toxoplasmosis, Syphilis, etc.
  • Other health problems such as Heart Conditions, Asthma, Lupus, or Rheumatoid Arthritis
  • Smoke, or use alcohol or drugs
  •  Are under the age of 18
  • Are over the age of 35
  • Are pregnant with twins, triplets, or high order multiples
  • Have a history of multiple miscarriages
  • Are carrying a baby who has a medical condition or syndrome
  • Experienced complications during a previous pregnancy, such as Preterm labour, Pre-eclampsia, Eclampsia
  • Birth of a previous baby with genetic problems
  • Are taking medications that may have adverse effects on you or your baby during gestation

 

Your doctor will use a formula to determine if your pregnancy should be considered high risk, using the information they have about your health and pregnancy.

How Will My Prenatal Care Be Different If My Pregnancy Is Considered High Risk?

 

If you have been seeing a family doctor or midwife, you may be transferred to an obstetrician to ensure you receive the specialized care you need. You may need extra ultrasounds and testing, and more frequent visits to your obstetrician. Additional genetic testing may also be offered. Depending on the reason your pregnancy has been labelled high risk, you may be asked to reduce your activity levels, change your diet, or make other adjustments to your lifestyle.

You may need to give birth in a specific hospital that offers the care you need. You should talk to your primary care provider about how your plans for birth may change.

What Can I Do to Have a Healthy High-Risk Pregnancy?

One way you can contribute to a healthy pregnancy is by improving the health of you and your baby.  This may be achieved by:

·       Attending the recommended appointments and tests

·       Eating a healthy diet

·       Taking all medication and supplements your doctor recommends

·       Following your doctor’s suggestions for activity and/or bedrest

·       Avoiding both first and second-hand cigarette smoke

·       Abstaining from alcohol and illegal drugs

A high-risk pregnancy doesn’t have to be scary. Always ask your questions as they arise. Get clarification from your primary care provider on anything you do not understand. Sometimes, the difference between feeling fearful and feeling safe is having more information.

Hiring a doula from Family Doulas of Ottawa is also great way to ensure you have someone to call with your questions and concerns throughout your high-risk pregnancy. Doulas provide that extra layer of support and guidance, including being in attendance during labour and birth, so that you never have to feel alone.  With the right network behind you, you can go through your high-risk pregnancy feeling informed and empowered.