Tips to Prevent Tearing During Childbirth

Many people’s biggest fear about childbirth is tearing.  Tearing is indeed painful and ranges in different degrees of severity. We have seen many women birth large babies without a tear and others tear birthing not-so-large babies. There are things you can do to prevent tearing or more accurately – minimize the risk of tearing. Here are our top tips of what to do, these are things you should do both prenatally and some great tips to do during birth to prevent or minimize tearing.

Prenatal Preparation Tips for Preventing Tearing

The list below is of things you should do during your pregnancy that will help reduce the risk of tearing during birth, it is easy to follow and require a relatively small effort to implement.

  1.  Hire a doula, take a Childbirth Education class, and learn relaxation techniques. This one is huge because being calm during birth, finding good positions, possibly choosing to forgo the epidural (no judgement and we support all) is going to lessen chance of tearing or lessen amount of tearing.
  2. Orgasms!  It’s not crazy- more blood flow to those tissues=good thing.
  3.  Nutrition. Learn more about nutrition for better skin elasticity. Look into foods with Omega 3, Vit E, Vit C, and Zinc.
  4.  Lengthen and Release tension in the pelvic floor. Find out how in a video posted to our FREE Facebook group. We should not have to PUSH SO HARD. If the pelvic floor is too tight (hypertonic) and does not yield well, it can make the pushing stage more difficult, which can increase the chance of tearing.
  5.  Balance the body. We know there are certain fetal positions that are easier to get a baby out and certain positions that can be more difficult for some moms. If mom’s body is balanced, baby is more likely to find a more optimal position. The One Strong Mama program has exercises and techniques designed to create balance in mom’s body so that baby can find a more optimal position.  We also recommend our friends over at Spinning Babies for techniques to be done during the 3rd trimester of pregnancy and during birth.

Birthing Tips

This list is of tried and true tips for how you approach your birth in order to reduce the risk of tearing during. I suggest you prepare yourself before the birth, arm yourself with knowledge and communicate your expectations with your provider ahead of time.

1. Consider going epidural free.

(note: we are not anti epidural) This will give more variety of positions for mom and also help mom to feel what is going on when crowning. If you do decide to go for the epidural, consider laboring down/passive descent where you allow your body to push the baby down most of the way, passively.

 2. Optimal fetal positioning. 

During birth, have some Spinning Babies techniques in your back pocket, or hire a doula who knows them, so that if needed they can assist you in gently encouraging baby into position. Ideally, this is not something that the birthing mom should be having to remember and think about during the process. Rather, it is best to let mom relax and go inward while having external support to encourage the best positions as baby makes their journey down and out.  

3. Avoid the episiotomy.

An episiotomy is a cut performed by provider and is more likely to extend into a more significant tear. They were done much more commonly in the past, but new evidence suggests that it is not often needed and can cause long term issues (1). Additionally, it is easier for our bodies to heal from tearing than cut because tears tends to happen around the cells and an episiotomy cuts through them.

 4. Safe environment.

This goes back to prenatal preparation. We need to get out of the fear-tension-pain cycle. Tension is not ideal for the mind OR the tissues. Create a safe place, wherever you are birthing. This may include things like dim lights, sounds and smells you enjoy, your own clothing, and people who love and support you.

5. Mother directed pushing vs. coached breath holding

(*****see our article on breathing the baby out) Additionally, when baby is crowning, slowing down!! When baby is on the perineum and there are strong sensations happening, sometimes we want to just push quick to get past it. But those strong sensations are our bodies way of telling us to slow down and let the tissues stretch.

 6. Maternal positioning.

When we push on our back it decreases the diameter of the pelvis, which will mean we may need to use more force to get baby out. More force can put a greater strain on the tissues. If a baby needs help getting out, squatting is amazing, as it increases the diameter of the outlet of the pelvis. But if baby is coming fast or upon crowning, switching to hands and knees, kneeling in some way, or side lying is optimal as these positions puts less strain/force on the tissues.

Tearing is not something one would mention as the “highlight” of giving birth and it’s best when it’s avoided. This article offers a wholistic approach for preventing tearing during childbirth rather than a one “silver bullet” type solution that may address one root cause. Please read thoroughly and see if it makes sense to you. Please feel free to comment or ask question on our email or in our FB group.

(1)Lappen, Justin R., and Dana R. Gossett. “Changes in episiotomy practice: evidence-based medicine in action.”
Expert Review of Obstetrics & Gynecology
5.3 (2010): 301-309.
FitzGerald, Mary P., et al. “Risk factors for anal sphincter tear during vaginal delivery.”
Obstetrics & Gynecology
109.1 (2007): 29-34.
Samuelsson, Ellen, et al. “A prospective observational study on tears during vaginal delivery: occurrences and risk factors.”
Acta obstetricia et gynecologica Scandinavica
81.1 (2002): 44-49.

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