I think it’s safe to say no one wants their vag to tear or get cut during childbirth. It can be hard to wrap your head around how a baby can possibly come out of “down there”. But, the fact is, it happens everyday. It happens all the time, and yes, ladies, you don’t always need to tear or get cut. It does, however, take more than simply writing it down on your birth plan.
Top reasons for tearing or getting an episiotomy:
- Impatience leading to forced pushing
- Impatience leading to doctor cutting
- Not enough elasticity
- Mother is too tense
- Big baby
Once you realize you want to work towards avoiding episiotomies and tearing I implore you to talk to your doctor or midwife.
Find out how often they perform episiotomies during childbirth and if they’re open to you to trying some of the techniques described below during labor.
First, I’ll talk about a massage and exercise you can practice during your pregnancy, especially the last 6 weeks or so, and then, a couple of tricks you can have up your sleeve at the birth.
Are you ready to get your nether regions relaxed and stretchy???
Let’s do this mama!
1. Perineal Massage
Especially great for first time moms. Unfortunately, there’s no evidence it will do any good for subsequent births 🙁
It will help prepare first time moms for the sensations and stretching you’ll feel during childbirth and improve elasticity of the perineum.
To begin with, trim your fingernails. You don’t need Edward Scissorhands up in there! Ouch!
A nice warm bath will help beforehand to relax the muscles. Then, wash your hands and find a gentle lubricant. Common lubricants are ky jelly (i’d avoid products with petroleum) Vitamin E oil or organic coconut oil.
To do self-massage, place your thumbs about 1-2 inches in your vagina. Keep knuckles of your thumbs together to prevent overstretching. Press down toward the anus and then to the sides of the vaginal wall. Hold there for a minute you should feel some pressure and stretching , but not to the point of pain. Then, slide thumbs back down and to the sides and repeat several times.
- Perineal Stretch
The perineal stretch is considered a gentle exercise and you shouldn’t feel alot of pressure that is possible with the massage. You’ll also stretch your hamstring, buttocks, and inner thigh.
Start off in table top position (on hands and knees). Tilt your tail bone under and arch your back like in cat pose and bring one foot forward to the the outer side of your hands. Reach your foot as far out as you can while remaining comfortable and lean forward into the stretch. Hold for a minute and remember to breathe. Come back to table top and do the other side.
- Warm Compresses
Can be as simple as warming up wet washcloths in a microwave or crockpot.
You’ll want to either sit on the warm compresses or hold them to the perineum if lying down when you get close to 10 cm. or start feeling the urge to push.
Some pressure on the perineum is also helpful for the mother to apply herself when it feels necessary.
- Controlled Pushing
Did you know if you didn’t do any pushing at all your body will work to push your baby out?
Of course, you’ll want to help guide your baby out because he/she is also doing a lot of work to turn and mold through the birth canal.
One of the major causes of tearing, and it baffles me that some hospitals will have you lay on your back and push your damndest to get the baby out, is pushing before you’re ready or too forcefully.
Think of blowing a bubble through one of the circle bubble sticks. If you blow too hard you’ll just blow all the liquid off the stick. But, if you blow soft and controlled you’ll make tons of beautiful floating bubbles to chase and pop.
Try to be in an upright position and wait to feel the urge to push ( this can be hard if you’ve had an epidural) . Some hospitals now have beds that will adjust so you can get into a squat with a squat bar to hold yourself up.
Bottom line…Let your body be your guide and don’t push with everything you’ve got.
Slow and controlled =less tearing.
- Warm Bath
You’ve relaxed in the bath before your massage and the same holds true during labor. The ultra warm water will relax your perineum along with the rest of your body which will help facilitate labor and make for a gentle delivery.
Try to stay in the water as long as it feels good and is permitted. If your at home or birth center getting a birth tub is a great option. A lot of hospitals offer tubs as an option in recent years, but they usually want you to get out for delivery. Research what options are available where you plan to deliver.
- Lotions and Potions
There is some controversy that massaging during labor/delivery actually causing more harm than good so I don’t suggest a full on perineal massage.
Nonetheless, some oil soaked on your warm compress or rubbed in and around the vagina will help keeps things slick. Use any carrier oil with a drop of geranium is suggested to help with trauma and tearing.*
I like to use a blend of almond oil which is a good source of Vitamin E and wheat germ which is known for improving scar tissue. You could also use some organic coconut oil .
Be sure your support team and nursing staff is not allergic to any of the oils or lotions you plan to use. I like to have a small variety on hand in my doula bag just in case 😉
7. Relax your jaw and mouth muscles
It’s common in childbirth to tense up your body to fight off the pain of your uterine contractions. You’ll actually be fighting the very movement of the baby through the birth canal! And, it will cause more pain than if you can relax and let things happen. I know it’s easier said then done, but your doula will remind you to relax body parts if they see you tensing up. A common place is in your mouth and jaw and many women see great improvements in their labor when they can fully relax theses facial features.
Remember listen to your body and do what feels good at the time.
*This statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent disease. Check with your care provider prior to use.
Birth Bag Items to Avoid Tearing and Episiotomy Check List
- 5 -10 washcloths to use as warm compresses
- Massage/Carrier oil
- Essential oil (lavender or geranium)
- Small crock pot to warm washcloths (Check with your birth facility ahead of time it may need to be inspected. A microwave, although may be more of an inconvenience, may suffice.)
Good luck on your delivery mama! If you’d like this advice you can search my blog for more helpful tips and follow Mind and Body Mama on facebook.
I also offer my I ❤ My Pregnancy Coaching so you can breeze through pregnancy feeling healthy and confident for delivery.