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Old 04-14-2013, 08:42 PM   #21
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Re: Midwife/Birth Center - Avoiding tears

I've had 5 babies. I tore with the first 3, although not badly. I had stitches with each of them. #1 took much longer to heal, and was unpleasant because of how the OB repaired the tear. #2 and #3 healed much more quickly, and with less pain, because the MWs were a lot more careful in their stitching, and they gave me better instructions for healing.

#4 was my biggest baby, asynclitic presentation, but I only had very minor skid marks that were healed within 2 or 3 days. #5 was a water birth with no tearing or skid marks. I didn't even use the ice packs after her birth.

IME, the best way to prevent tearing is to follow your body's lead in pushing, use warm compresses and/or olive oil perineal massage during pushing. I also think it is much better to birth in a position NOT on your back. Squatting, all-fours, etc. help to open up the birth passage to its fullest, putting less pressure on the perineum. Water birth is one of the best ways to prevent tearing.

If you do tear, herbal sitz baths, ice packs, and vit. E or calendula are your best friends. Sit on a cushion, keep your legs together, and try to move around as little as possible. Arnica helps with swelling and bruising.


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Old 04-15-2013, 01:39 PM   #22
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Re: Midwife/Birth Center - Avoiding tears

I tore with my first but not badly, got 2 stitches. With her I'd had an epidural and coached pushing at a very anti natural anything high risk hospital. Recovery wasn't bad though. Mentally was way worse than any pain. I kept imagining something going wrong down there and like I said I hardly tore. With my second I had a failed epidural and the only coaching the midwife did was to tell me to slow down a minute so I wouldn't tear. I didn't tear at all. That recovery was way better because I had nothing to worry about, ya know? No worrying over stitches down there or anything. So I'd say painwise, tearing really isn't bad but mentally is what got me. And I have an extensive medical history with lots of surgeries...but something about being stitched up down there!
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Old 04-25-2013, 08:51 AM   #23
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Re: Midwife/Birth Center - Avoiding tears

I had a moderate tear, but surprisingly that didn't bother me as bad as the 'backdoor' area. I just didn't feel right for a couple months after my daughter was born. It just felt veryyyy uncomfortable to go #2, and I didn't even tear there!!
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Old 05-11-2013, 09:01 AM   #24
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Re: Midwife/Birth Center - Avoiding tears

My first two were born in the hospital with epidurals. First time I had an episiotomy and it was hands down the worst recovery for me. I could barely sit or stand for two weeks without a great deal of pain. It was awful. Second time, I asked not to be cut, and the dr was pretty cross about it, and made a big deal about how I would regret it. I did tear and required stitches, but recovery was light years better than the first time.

Last two were both natural births with a midwife. I prepared for my 3rd with perineal massage. The third was my largest baby at 9lb 12oz. Neither one did I tear or require a stitch. Both midwives had excellent records regarding tearing. One had never needed to do a single stitch.
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Old 05-13-2013, 12:39 PM   #25
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For DS I delivered at a hospital with an OB and got an episiotomy. With DD I had a water birth with a midwife and no tearing at all. Much easier recovery! Good luck!
Denise, building a life with B my farmer, Mom to L 09.2006, W 12.2006, A 04.2013, and B 09.2014 and one angel 10.24.2013
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Old 05-13-2013, 10:25 PM   #26
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Re: Midwife/Birth Center - Avoiding tears

Originally Posted by ~Cricket~ View Post
Waterbirth has a much lower tear rate. If you are able to labour/deliver in the water, I'd recommend it! It also is great for natural pain relief!

Some people like to do perineal massage to loosen things up a bit, with some vitamin E or olive oil or evening primrose oil. I've never tried it, but apparently you have to wash up afterwards, because the oil can increase your risk of vaginal infection. I think the jury is still out on how effective the massage is, but some women definitely believe it helps.

I had warm compresses put on my perineum as the baby crowned with my first. That felt great, IMO, helped to direct my pushing, and I think it helped me to not tear as well. I've never had anything that needed stitches, just a few grazes, which can sting pretty good! My doctor said that the other reason I didn't tear was because I was able to pant when she told me to, and stop pushing for a minute to allow the skin a little extra time to stretch. If you can pant through the "ring of fire" I believe that's supposed to be the key. Sometimes that's just not possible - your body might decide to do what it wants!

Delivering in the squatting position (while great for bringing down a stuck baby) is known for high tear rates. I believe all fours, and possibly semi-reclining are better. (I've delivered semi-reclining each time.)

Finally, talk to your midwife about your concerns and see what she has to say. Let her know that you want to do your best to avoid a tear, and would like her help during delivery to accomplish this.

If you do tear, the peri bottle afterwards when you pee is essential! And your midwife might have an herbal bath for you to soak in, and to keep in your peri bottle to speed healing. Adding some sea salt to your bath can help as well.

All the best!
I didn't know this. I did everything "right" to avoid tearing and ended up with a second degree tear. I had a home waterbirth while squatting and had no clue that position could contribute to tearing. Doh!
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Old 05-14-2013, 08:03 AM   #27
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Re: Midwife/Birth Center - Avoiding tears

Try to avoid an episiotomy...healing from a natural tear is much easier.

I had a 3rd degree tear after #1 (hospital birth, induced labor, epidural) & was sutured.

I had a 3rd degree tear after #2 (birth center, spontaneous labor, natural birth) & healed naturally without sutures. I actually preferred to heal naturally...I felt like I healed more "normally" than with stitches, and will do the same if I tear this time.
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