How to Prevent Tearing in Childbirth

Vaginal tearing during childbirth is something that scares most women, especially those who are having their first pregnancy. Vaginal tears occur during childbirth, where the child’s head is either too large compared to the size of the vagina or the vagina does not stretch easily to allow passage of the child. 

Vaginal tears can affect the skin around the vagina or extend to affect the anal sphincter, depending on the degree of tear. 

It’s normally not easy for women to feel the vaginal tearing during delivery because of abdominal contractions during labor. They get to notice it after giving birth. 

Some vaginal tears do take a short time to heal while others take quite some time and even need special treatment to heal. 

Even though it is difficult to completely prevent tearing in childbirth, researchers have shown there are ways to reduce the risk of tearing during childbirth as discussed below. 

Before Childbirth

Practice Birth Positions Ahead of Time

Women’s position during childbirth determines the success of childbirth and chances of vagina tear. Positions where the sacrum is pressed against another surface like a stationary object might lead to vaginal tear. 

Some of the positions that should be considered to prevent tearing are side-lying, kneeling, and squatting. 

Giving birth in a side-lying position allows the presenting part to descend more slowly, reducing pain and tear.  Kneeling and squatting uses the gravity advantage which helps the baby to move down through the pelvis. Squatting further increases the size of the pelvis hence it gives more space for the baby to maneuver in the pelvis and descend.

Consider Pelvic Floor Muscle Contractions Exercises

Pregnant women need to practice pelvic floor exercises to strengthen the muscles in the pelvic floor of the abdomen. This is a practice that should be done even after child delivery to make pelvic floor muscles function properly and experience less stress during activities like coughing, sneezing or even walking around. 

When pelvic floor exercise is combined with perineal massage, it reduces the chances of tearing to a great percentage. It reduces the chance of anal sphincter tears and women experience less pelvic pain after childbirth.

Perform Perineum Massage

Perineum massage is a manual technique of stretching the vagina in preparation for childbirth. It’s a technique that is especially beneficial to those having their first pregnancy. It enables them to understand their body and sensations that are present during birth.

Perineal massage before birth stimulates blood flow to the skin around the vaginal opening and between the vagina and rectum (perineum), hence enabling the skin to stretch over the baby’s head during the delivery stage, increasing elasticity, and reducing the need for episiotomy or vagina tearing. 

Prepare a Perineal Tear Prevention Plan

It’s a good practice for women to visit midwives or physicians to help educate them on ways to prevent tearing during childbirth. Women can agree on perineal tear prevention strategies that they can use before labor starts. 

This can be achieved through good visualization of the perineum during pushing, manual perineal support, controlled delivery of the fetus’ head, and the application of a warm compress of the perineum during pushing.

During Childbirth

Pushing Techniques

There are two major pushing techniques. Closed glottis pushing is when you take a big breath, hold it, and then push for the length of the contraction. Open glottis pushing involves the use of an active exhale to push when the urge develops. 

Most people favor the Open glottis pushing method because it allows more controlled descent during baby delivery, minimizing the strain on the perineum that causes tearing.

A pelvic floor physiotherapist can have a review of the breathing process and pushing techniques and give further directions. 

Perineum Massage

Keeping perineal muscles warm works because the perineum, as a body muscle, stretches best when it is warm. When a woman has a midwife or nurse who applies a warm compress to the perineum before and during pushing of the child, it can be useful. 

It can also be achieved by taking showers during labor time. This warmth helps reduce the pain experienced by women.

Adopt Fewer Vaginal Examinations During Labor

Vaginal examinations might reduce or increase vaginal tearing during childbirth if they are not properly performed. Having more vaginal examinations of about six onwards can increase the chances of tearing. It’s advised to consider fewer examinations and even perform other medical examinations that aim to improve child delivery.

Conclusion

It may not be possible to fully prevent tearing during childbirth due to several reasons associated with vaginal stretches. However, there are different techniques that can be adopted to manage the degree of tearing and prepare pelvic muscles for childbirth. 

As discussed in the article, these techniques can be considered to keep women more comfortable and ensure their childbirth process is successful. One of the most effective is performing perineal massage before birth.