Six Ways You Can Minimise & Prevent Vaginal Tears During Childbirth

Around 90% of all women experience vaginal tears during childbirth. When considering labour and birth, one of the biggest fears for women (other than the pain) is the potential tearing of their perineum that may result in extended recovery time due to stitching after giving birth.

Vaginal tears during childbirth, also called perineal lacerations or tears, occur when the baby’s head is coming through the vaginal opening and it is either too large for the vagina to stretch around or it is a normal size but the vagina doesn’t stretch easily.

Tears can range from affecting only the skin around the vagina to involving the anal sphincter (third- and fourth-degree tears). Although, there is no guarantee that you will be able to prevent vaginal tears during childbirth, many research suggest that taking these specific steps can help you minimise the risk of severe tears.

See suggestions below:

1. Perineal massage:

Your health care provider may recommend perineal massage at home at the end of your third trimester, before the start of labor. You can do this yourself or with the help of your partner.

Place your (or your partner’s) lubricated thumbs shallowly into your vagina (no more than three to four centimetres) and press the perineal floor down towards the bowel and to both sides until you feel a slight burning or stretching sensation. Maintain the pressure for about a minute before resting.

Studies show that perineal massage reduces your chance of tearing during birth. Just rub sunflower, olive oil, vitamin E oil or coconut oil into the skin between your vagina and anus once or twice a day, starting from around 34 weeks onwards.

If you are not comfortable with the idea of perineal massage remember it’s not a ‘must’.

2. Use Warm Compresses:

Placing a warm cloth on the perineum during the second stage of labor might help. Using hot, wet flannels or towels pressed on to the perineum when your baby is being born can soften the skin as it stretches.

“For many years midwives have used moist, warm packs on the perineum to reduce pain and tearing as the baby’s head is born,”

says Hannah Dahlen, spokeswoman for the Australian College of Midwives.

3. Keep Calm While Pushing

You don’t have to push with all of your might while holding your breath in order to birth your baby. During the pushing stage, the fetal ejection reflex is moving the baby down and out of the uterus, into the vagina and out into the world.

Breathing with your contractions allows your baby to descend slowly and it will help you have less pelvic floor trauma. Listen to your body. If it’s too much tension breathe through it and allow your body to stretch as your baby descends lower. That way, you significantly lower your risk of vaginal tear.

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4. Don’t Choose A Flat Birthing Position

As opposed to the traditional method of lying on your back, which reduces the size of your pelvis and doesn’t utilise the natural effect of gravity. To minimize the chances of tearing, the best positions are:

On all fours, on hands and knees.
Leaning forward in a supported standing, kneeling, or sitting position

Squatting and kneeling are also great pushing positions, however, if the woman’s knees are too far apart the perineum will be stretched sideways and may increase the likelihood of tearing. Ultimately, the best position while pushing is the position that your body chooses. Listen to your body and do what feels best and right for you.

5. Pelvic Muscle Exercises

You may think that Kegels are counter-productive when it comes to preparing for birth, but that couldn’t be further from the truth. Yes, you need your pelvis and vagina to be relaxed and open during the second stage of labor, however, you also need pelvic floor strength to help baby descend and deliver.

6. Choose Your Care Provider Wisely

It would be stating the obvious to say your choice of hospital and doctor/midwife can greatly affect the outcome of your birthing experience. Some care providers are more aggressive and instructive during pushing and others are more patient and gentle.

During your prenatal visits, ask your doctor about how they assist their patients during labour, including their opinions on episiotomy and natural tearing. Being on the same page with your caregiver can calm your nerves and lessen your risk of a tear.