Tearing during labour is something that a lot of moms worry about. In this blog we will share some important information about tearing and also share a few helpful ways to reduce the chances of having a significant tear during birth.
Four Degree’s of Tearing
There are varying degrees of tearing that can happen during the second stage of labour (the pushing phase). While many women will experience some form of tearing, for the majority, it will be a first or second degree tear.
A first degree tear happens when the skin has torn very mildly and therefore requires no stitches or only a few. A second degree tear involves both skin and muscle but is also quite mild and usually needs only a few stitches. Both first and second degree tears typically heal quite quickly and provide very little discomfort for mom.
A third degree tear is in the vaginal and perineal skin as well as the muscle that extends around the anus. A fourth degree tear is the same as a third degree one with the addition that it extends into the muscle around the anus.
It is important to note that less than 1% of women who experience tearing do so with a third or fourth degree tear.
That being said, there are some ways to help to reduce the chance of having a tear or at least the degree with which you tear during labour.
1. Choose a Birthing Position that is Comfortable for You
Choose a birthing position that is comfortable for you and comes instinctively can reduce the likelihood of tearing. The less stress or stretching on your perineum, the better. When women are lying down or in semi-reclined positions it reduces the size of your pelvic floor by putting pressure on your tailbone and perineum, which may increase the chances of tearing.
The positions which put the least amount of stress on the perineum include:
On all fours
Lying on your side, or
Leaning forward (whether standing, kneeling or sitting).
Whether you are giving birth at home, at a birth centre or in the hospital, having a discussion with your health care provider about birthing positions that you feel as though you would like to try prior to labour can be very helpful.
2. Labouring in Water
Not only can labouring in water help in decreasing your discomfort throughout labour, it can also reduce your risk of tearing. Many women find labouring in water to be very comfortable and to promote a relaxed and peaceful birthing environment.
3. Perineal Massage
Perineal massage is an exercise some women like to use during the last few weeks of pregnancy to help reduce the risk of tearing. It is an exercise where women are taught to insert 1-2 lubricated fingers about 2 inches into the vagina and apply pressure, first downward for 2 minutes, and then sideways for 2 minutes. (https://www.scienceandsensibility.org/blog/what-is-the-evidence-for-perineal-massage-during-pregnancy-to-prevent-tearing)
Perineal massage can help some women get more comfortable with the sensation of the perineal tissues stretching, which can aid them in coping during the pushing phase of labour more effectively. Also perineal massage may reduce the likelihood of having an episiotomy which lessens the chances of a more severe degree of tearing. The benefits of perineal massage seem to help women having their first vaginal birth as opposed to subsequent pregnancies.
4. Using a Warm Compress
When the baby is crowning, a warm compress held to the perineum can help in reducing tearing, as the warmth can promote blood flow to the area. The warm compress can also feel very good and provide some relief to the labouring mom.
Is tearing during labour something that you have been/ are worried about? I would love to hear from you!
As a Doula I am here to help make your pregnancy, birth and early days of parenting as stress free as possible. If you ever want to chat about anything feel free to contact me 🙂 email@example.com or over on Facebook: The Blissful Doula Sudbury.
If you are looking for more information on Tearing During Labour or any of the topics listed above, the following is a list of great resources.