This is the first post for a new ongoing series, to answer YOUR questions about birth! Fun, right? To submit a question, take this quick questionnaire and be featured on the blog!
*Disclaimer: I am not a medical professional. I am trained to support women and couples through their birth experience, but I leave the medical side of birth for medical providers. Please talk to your health provider if you are concerned about the health or safety of you or your baby.
Today’s burning question(I couldn’t resist)....
Will it hurt if I tear???
A common concern for women is tearing. No one likes the idea of causing injury to a perfectly good perineum. (And if you've already had a tear, take comfort- our bodies are really good at healing and repairing themselves, especially with a little help from a knowledgeable provider!) A good place to start is what we can do to prevent tears in the first place, after all, prevention is the best medicine!
A few tips to avoid tears during birth:
1- Eat the right food.
Tissues handle stretching much better when they are healthy. A well-balanced diet that includes adequate protein, healthy fats, whole foods, and plenty of water produces healthy, elastic skin. Be aware, changes in your diet need to happen months in advance to produce the full benefit of healthy stretching during birth! An early pregnancy class can help you get a head start on optimal nutrition.
2- Listen to your body.
Seems simple enough, no? Yet the majority of women who give birth in hospitals give birth on their back even though we know that isn’t optimal positioning for pushing out a baby. When women are able to push in the way that feels best to them (squatting, hands and knees, side-lying, holding onto a squat bar, lots of options!) birth is better for the mom, and better for baby.
3- Find a supportive provider.
Make sure you talk to your provider, and instead of asking “Will you let me push in whatever position I need to?” ask “How do you see most women pushing during birth?”. This will help give you insight into the way they handle birth, as well as how supportive the nurses and hospital will be of your choices. You will also want to find out what their episiotomy rate is. Current evidence tells us that routine episiotomies are discouraged, so if your provider has a high rate you might want to look elsewhere.
4- Listen to your body.
Oh, I said this one already? Yep. It’s that important. As you near the crowning phase of birth, when the largest part of babies’ head passes over the perineum, it’s vital that you listen to your body when you feel any burning or stinging! It’s a sign to you to slow down and pant or breathe through this part to reduce the risk of tearing. Women that are told to push and hold for a certain amount of time(such as coached or "purple" pushing, which is where you are told to hold your breath and push for a count of 10) are very likely to end up with a tear, sometimes much worse than if they were simply allowed to listen to what their body was telling them and take a little more time. Again, talk to your provider, other women who have given birth with them, and find out if this is the norm!
Okay! On to the question. Will it hurt if I tear?
In short: Most likely not in the moment of birth. Many women can’t even tell when a tear happens, and didn’t feel if/when they did. The reason for this is that at the moment of crowning, when a tear would normally occur, the tissue surrounding the perineum is stretched tight, the skin turning white, effectively numbing the sensation in that area. There is also a lot else going on at the moment and you will be too distracted with other thoughts and sensations to notice a tear.
If you have a tear that requires stitches, your provider will numb the area with a local anesthetic so you may only feel the needle momentarily before the medicine takes effect. *Sometimes the perineal area doesn't numb as evenly or effectively, so this is another reason it is even more important to do all you can to gather a supportive birth team and become educated at spotting red flags long before the time of birth.
Afterwards you will usually be sore for a few days, often whether you had a tear or not, since you used a lot of muscles to push out your baby! Follow your provider's recommendations(and making sure the research you've done supports it) on healing and caring for the area is best.
Callie teaches Birth Boot Camp Childbirth Classes and serves clients as a Birth Doula in Flower Mound and Denton County, TX. Some of her favorite things are birth, Brene Brown, her three precocious little girls, making new creations for her family or Etsy shop, and stashing treats in her closet for a rainy day. You can check out other posts on her blog or contact her at firstname.lastname@example.org.