Birthready ▶ Reducing Perineal Tear

Take away your fear of tearing

You can prepare now and feel more confident in your capacity to birth your baby

A new father shares his experience in having supported his partner with this part of their birth preparation:

  1. Make changes in your diet so that you are eating and enjoying good nutritious food.  This will increase the elasticity in your tissues for stretching.  Minimize sugars, simple carbohydrates and processed foods.  Try to eat more local and fresh fruit and vegetables, lean meat, nuts, grains and legumes.  Vitamin E is also helpful.  Evening primrose oil in the vagina and on the perineum also helps prepare the tissues.
  2. Exercise during your pregnancy is important.  Find an activity that you enjoy and work out 3 times a week. Some options are walking, swimming, pregnancy focused yoga, dance, etc.  This improves your circulation and tones your muscles.  Well-toned muscles are able to stretch and contract back to shape with greater ease.   Exercise overall will help you be physically stronger, have more physical and mental stamina and make you feel better.
  3. In pregnancy prepare your vagina and perineal tissues with gentle massage and stretching.  5 min every day in the last months of pregnancy helps.  Our body can hold tension (for physical or emotional reasons) and is often unsymmetrical.  All which influence the space we make available for our baby.  With a partner, or on your own, you can do internal massage to help release tension, increase circulation, practice your breathing into your birth passage and feel more comfortable and safe with the sensations associated with that part of your body.
  4. Avoid unnecessary interventions that interfere with the natural labour process.  Induction and augmentation for example change the speed in which your muscles will relax and contract, thus compromising blood flow and the time needed to stretch gently.  An epidural severely limits your movements that can create uneven stretching, forced pushing, increase use of episiotomy, vacuum extraction and forceps.  All these increase your risk of tearing.
  5. Use positions that help gravity to assist (or to take gravity away if you are having a fast labour).  Avoid lying on your back to push.  If you end up on the bed it is better to lye on your side or be up on your knees with your arms over the raised bed head.   Squatting and the birth stool can put undue pressure on the perineum but can also be useful to help baby descend if the pushing stage is not progressing.  Once baby starts to crown, it can be better to be on your hands and knees.
  6. Breathe in such a way that directs your energy and oxygen to your cervix, vagina and perineum.  Focused, flowing, calm and confidant breathing allows for well-oxygenated cells to be elastic as need be.  It will help you visualize what your body is doing so that you are cooperating with it rather than resisting it.  Directed pushing instructed by someone else is usually unnecessary if you can feel your way through the sensations yourself.   Go slow with the 2nd stage of pushing.  Give yourself time to gently allow your baby to descend into the birth canal and the perineum especially.  The rest between the contractions is enabling your body to adjust to the stretching it receives during the contraction.   Keep your throat soft and open.  This directly connects to your vagina being more open also.
  7. Sometimes you can feel stirred by unexpected emotions.  If they cause you fear, pain and tension, express it to those you feel safe with.  They will do their best to give you extra support to help you through.
  8. Ask your care provider to support your perineum with warm compresses, oil, gentle counter-pressure and observation of the skin tissue and speed as the baby’s head passes through.

This list of ideas is not exhaustive.  Other alternative health modalities would have other suggestions to add.

One of the aspects of Erika’s education that we feel helped the process a lot and assisted Stef in having a 2.5 hour, drug free labour was the perineal/internal massage. The moment Erika started explaining the techniques to us it made perfect logical sense. The more healthy and relaxed all those muscles are before the birth the better they cope with labour and most importantly the better they recover (both these points were true for us). Using these massage techniques as well as the hypnobirth and meditation techniques allowed us to have an extremely relaxed pregnancy and birth. Thanks so much Erika for your support and education which we feel was integral in the ease and speed of the birth of our beautiful baby girl Loup!

Philip Romeril


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