Natural Birth

Tears (as in nature's Epi, not crying!)

Hey all, while I'm working on mentally and physically preparing for the pain of contractions, I find myself (as an FTM) really freaking out about tearing. I'm not sure why this scares me more than anything else, but it does. As such, I'd like to hear from STMs: did you tear? How bad? Was it a big deal to you or did you not really care? Did you find that any of the recommended techniques (perineal massage, compresses, certain positions, etc.) for avoiding a tear worked for you or not? Did you get an epi to avoid a worse tear? How painful was it and did it affect sex later? Any insight is helpful.

Thanks in advance and sorry if I'm being a wuss!

"Can I call your baby 'Ze Munchkin,' or 'ZM' for short?" - my best friend

Re: Tears (as in nature's Epi, not crying!)

  • I think it's an understandable fear.  I've had two natural births and both times had a second degree tear.  I can honestly tell you I was not aware of the tearing as it was happening.  I had to ask the midwife after if I tore.  Getting stitched up was not so fun, but at that point you have your baby on your chest and it's a good distraction.  I honestly thought recovery was not that bad, and it has not affected sex.  
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  • I had a second degree internal tear because LO had a nuchal hand.  During delivery my OB was doing a perineal massage to help reduce the tear.  Without the massage he said I probably would have torn worse.  During delivery I did not feel the tear happening because I had so much adrenalin going and the pressure from LO in the birth canal.  The stitches hurt worse than delivering LO because the OB did a few in an area that was not numb.  In my situation I would have torn regardless of what position (I delivered in the side position) I was in because of LOs hand.  The tear really hurt during recovery because I did not take any pain medication.  I had a hard time getting up and down holding LO and had to have her handed to me for @ 1 week.  The tear also took awhile to heal (9 weeks) and DTD was difficult at 12 weeks.  We had to take sex slow in the beginning and do lots of foreplay first so that I was really in the mood.  Now it is like nothing happened down there and I feel totally normal.  Tearing seems scary now but when you are in L&D it will be the last thing on your mind, so try not to freak out now.
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  • I wasn't afraid of tearing but alas I tore badly. I had a bad second degree year that I ended up having to transfer to the hospital after my homebirth for. I don't think I would have torn but I had a complicated labor. DS was very malpositioned and I was pushing extremely hard. No one told me he was going to come out super fast and all at once if I continues pushing as hard as I was! So my giant baby flew out and tore me up and down.

    The worst was recovery. I didn't even know I tore and couldn't feel it at all. Then once my birth high started to fade, it was really sore for a couple weeks. It certainly wasn't fun but it wasn't a huge deal either. You'll be ok!

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  • I tore with both of my natural births.  I can honestly say I had no idea, they told me after.  I think you don't feel the actual tear b/c there is so much pressure on the skin that circulation is cut off before it tears.  (just a guess).  There is so much going on anyway and feeling the baby move through your birth canal kind of takes up all your attention and energy.  By the time you know if you tore or not (for me) I was so happy to have my baby in my arms I couldn't have cared less. I healed just fine from both tears.  My biggest issue with after birth is the hemorrhoids! 

    Reichley Mama
  • I had an epidural with DS1 (but ended up feeling pushing/crowning) and med-free with DS2.  I had 2nd degree tears with both.  I did not feel myself tearing at all with either and the ring of fire lasted seconds with both.

    The med-free birth it did hurt more while stitching up, but that was about 5-10 minutes and I was on a high anyway from doing it med-free.

    My recovery with med-free was actually a lot faster and better than with the epidural.  I didn't push it and did the sitz bath, witch hazel pads, water bottles etc.. and honestly don't remember being too uncomfortable.  With the epidural tear I did not heal all the way by 6 weeks but honestly did not know it, I was not in any pain or anything.

    I chose not to have sex for at least 3 months after each baby although I'm sure I could have.  I just didn't want it to hurt at all and it didn't.  

    I know the idea of tearing is really scary but in the grand scheme of my birth experiences it was nothing.  I did try perinial massage a couple of times but was very uncomfortable with with it.  Also, both nurses/doctors tried to get me to slow down pushing as not to tear but I couldn't stop. 



    Natural M/c 12/13/08 at 8w5d 

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  • I had a third degree tear. I had to ask if I tore; I didn't feel it and the high after the birth totally overwhelmed any pain. They gave me some numbing shots and stitched me up. It healed quickly and fine.

    I don't think anything would have helped, as my baby was face up (occiput posterior) and did not turn. It was just a bad position. I pushed for 90 minutes, so it wasn't too fast or anything. Birthed on my hands and knees, which was a good position for an OP baby. I won't be doing anything differently this time; I don't think anything prior to labor does a thing.

    Sex is fine now. It took a few months, but I think that's sort of normal tear or not.

  • I had a second degree tear with DS2. Honestly, I don't really remember it happening. They numbed me and stitched me up afterwards, and the shot seemed more painful than tear. It hurt to sit certain ways for a few weeks, but I was in good shape by about three weeks PP. I wasn't particularly fearful about it, though.

    It hasn't affected sex at all for me, and I didn't do anything special to try and prevent it before or during labor.

    DS1 - Feb 2008

    DS2 - Oct 2010 (my VBAC baby!)

  • It's normal to be worried about tearing! I was, too. I'm going to preface my response by saying my experience is not the norm. It could have been a lot worse but it is also worse than most moms experience. Please keep that in mind.  

    Did you tear? Yes. How bad? It was a second degree tear, but it was a pretty big one (cervix to anal sphincter). Was it a big deal to you or did you not really care? At the time I didn't care one bit. There's a lot of, uh, stuff going on down there when the baby is coming out. It is all one big blur or pressure and pain, but it only lasts for a second. As soon as the baby came out it was gone. Did you find that any of the recommended techniques (perineal massage, compresses, certain positions, etc.) for avoiding a tear worked for you or not? We did not really do anything. The midwife did compress my perineum while I was pushing but I only pushed for 15 minutes and he came all out in one push. I didn't have a lot of time for stretching. She told me to slow down but I told her I didn't want to and I didn't care if I tore. I just wanted him out! In retrospect she was totally right. With my next baby I will definitely remember the healing process and slow down. Did you get an epi to avoid a worse tear? No. In fact I think it would have hurt, not helped, in my situation. If you take a piece of paper and try to tear it it gives some resistance. If you cut a little piece of it first it gives no resistance to the tear. In my opinion, epi's are only useful to direct the tear (ie I would rather tear down to my perineum than up to my urethra). How painful was it and did it affect sex later? To be honest the recovery was hard. I couldn't sit without extreme discomfort for at least a week and couldn't sit somewhere hard (ie the floor) for at least six weeks. I felt fantastic energy wise after the birth...the tear was the only thing holding me back from feeling like normal. We did not have sex until 12 weeks postpartum because I was so afraid. It was not bad at all. It was uncomfortable (and still is) but not painful if you go slowly and make sure there is enough foreplay.

    I don't know how well I could have prevented what happened. For the next baby I plan to drink a lot of water during pregnancy to keep my skin as elastic as possible (I got a ton of stretch marks, too, and I have heard this helps), do perineal massage daily with oil from 32 weeks on, and I plan to have a water birth if possible.

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  • This is great, everyone! Thanks! Based on this feedback, I think I'll do two things: one, relax a little since it sounds like tearing isn't as horrible as I'm imagining, and two, instruct my doula beforehand to encourage me to push SLOWLY, maybe just breathe through every third contraction or something. Thanks again!
    "Can I call your baby 'Ze Munchkin,' or 'ZM' for short?" - my best friend
  • image mlrafiki:
    Did you get an epi to avoid a worse tear?
    i can answer this one as I had an epidural with my first and medfree with my second. I ended up with a second degree tear with my first child and barely anything with my second. I am nearly certain that my second degree tear came from a combination of pushing too hard and too fast with my first. I had no idea that its a good idea to ease the head out slowly so the area can stretch to accommodate the head so I was pushing as hard as I could and had absolutely no biofeedback telling me to slow down which I did have with my second. Would have also been nice that a doctor or nurse slowed me down too but alas they were just telling me to push as hard as I could. My second child's birth was so much better because I could tell when I needed to ease up on the pushing because my body told me so.
  • I ended up in a position where I had to get an epi and rest or I would have had to get a csection. I took the epi so I didn't feel anything but pressure when I pushed my daughter out. I had a second degree tear but didn't actually feel myself tearing. It was painful after the fact and it took awhile to heal but it wasn't the end of the world. 
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  • I was terrified of tearing and I didnt tear at all. I credit a waterbirth, not pushing in a supine position, and/or inserting EPO capsules vaginally starting at 36 weeks. Traditionally EPO is used to soften the cervix, but my midwife also believed it to reduce perineal and vaginal tearing.
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  • I had tiny first degree tears both times, no stitches. I was a bit sore with #1 for a weekish, felt perfectly fine with #2. I didn't do anything special to prevent tearing, just great luck, but I did deliver in the water in the position that felt right at the time (hands and knees squat). 

  • You are NOT being a wuss, you are being prepared. Before labor my biggest fear was tearing and getting an episiotomy. Well my biggest fear occurred.

    I made sure to tell my doctor my fear and he did everything he could to prevent it. He did a massage, and compress but once labor started it didn't help. He didn't want to alarm me, but had to do an episiotomy. I knew he did it though, because I could feel it. It burned more than it hurt. After I delivered DD I knew I had tore just because of the amount of blood. I didn't feel the pain of tearing. To be honest, pushing my DD out was the most amazing feeling ever, so I was still on that high. Once they started giving shots and numbing it got a little painful. I think if the had not taken away my DD it would have helped to mask the pain. In the end I ended up with a third degree tear with some internal tearing.

    When I went back for my 6 week check up I still had majority of my stitches so sex was not even an option. I was so scared the first time but it didn't hurt.

    Best advice I can give. If you have a boppy pillow, take it to the hospital, and atleast leave it in the car. I had almost an hour ride home, so I sat on that and barely felt any bumps! Good Luck!
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  • I agree!  Push slowly and breathe.  If I had taken my time I don't think I would have tore.  BUT that said, it didn't hurt when I tore.  The shot to numb afterwards was worse and I've had no issues with any of them.  There was a lot each time since I pushed really hard and they were out within 5-10 minutes.  I didn't give myself enough time to stretch at all.  I think anything would have helped a little but time and slow pushing would have been the best help.  Just my 2 cents. 
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  • I was more scared of tearing than anything else with my first.  I had a second degree tear with him though, and I was not aware of it happening and it did not take long to recover at all.  Sex was unaffected.  In fact, I got pregnant with baby #2 just 6 months later, haha ;)  And with baby #2, I had no tearing.  With baby #1, the MW was doing a lot of massage, rubbing, touching, etc.  She was actively trying to prevent a tear.  With baby #2, no one put a hand on me at all and they just encouraged me to push slowly, gently, and whenever I was ready.  I totally think slow, gentle, controlled pushing prevented a tear with #2.

    All that said, again, even with tearing the first time - it was so much less a big deal than I had imagined it would be.

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  • I had a second degree tear as well. I, as with PP's, was not aware I had torn until my MW said she'd have to stitch me up (I had 9 total stitches).

    We did warm compresses during pushing (which felt nice) and my MW had me start to push, then hold it there as prevention. I don't know how effective the stopping pushing part was, because, obviously, I did tear, but I don't think it was until the very last push that I did so, so maybe it helped?

    Truly, in the midst of pushing your LO out, you don't really care that you will tear, and though needing to be stitched up is like adding insult to injury, it's not the worst thing in the world (just tell them to be generous with the numbing medicine!), plus, you'll be in such a "oh my gosh, I just had a baby!" haze that you'll know they're working on your hoo-ha, but it won't be your first priority by any means!

    Healing with a large tear is a bit rough for the first few days, especially for the first few trips to the restroom. My advice, use the peri bottle (with lukewarm water) and ice packs, and invest in some Earth Mama Angel Baby Mama Bottom Balm (you can get it at Whole Foods or on Amazon) and start using it shortly after birth (when you're feeling brave enough to actually touch down there) . I didn't notice significant healing or decreased pain until I started using the balm on about day 7. Seriously, the stuff is amazing!


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  • I had a second degree tear and I fully attribute it to my panic during delivery. I had a traumatic birth experience because of a horrible OB and I pushed that baby out as fast as I could to avoid her making it back for his birth. I think controlled pushing would have made a huge difference.
    Pg with #2
  • I had one tiny superficial tear that required one (maybe two) stiches. I felt nothing and had no idea I was tearing. It was NBD.
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  • image mlrafiki:
    This is great, everyone! Thanks! Based on this feedback, I think I'll do two things: one, relax a little since it sounds like tearing isn't as horrible as I'm imagining, and two, instruct my doula beforehand to encourage me to push SLOWLY, maybe just breathe through every third contraction or something. Thanks again!

    Definitely what would have helped me is if I had slowed down while pushing. I had a 22 hour labor, had been awake for 26, and was exhausted, so I pushed like a crazy woman as soon as my body gave me the signals to do so! Dd was 9 lb 3 oz, and it only took 15 minutes. My doctor rubbed oil on my perineum as I pushed, which did help, seeing as I didn't tear on my perineum lol. I still got away with only 3 tiny tears, 4 stitches total. 2 of them were on the inside, the third was on my labia minora. I think what kept me from tearing worse was refusing to listen to the nurses who were trying to get me to "purple push" and count to ten. I pushed with each contraction, and breathed out as I pushed, breathed in and steadily while I waited on the next contraction. 

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  • That was my biggest fear with DD 1. Don't let it stress you too much. With DD 1 I had a superficial tear that only needed two stitches, her shoulder was stuck. With DD 2 ( who also had her shoulder stuck and was a home birth) I ended up with a 4th degree tear and had to go to the hospital to have surgery to repair everything. Honestly, I didn't feel the tear at all and the only time it was painful was while they were checking the tear at the hospital. Even recovery hasn't been bad. I've only taken IBprofin for discomfort, which only lasted about a week. Nothing could have prevented the tear this time, but I'm okay with it.
  • I was absolutely in the same boat as you with my first pregnancy. I was so afraid of tearing, it was just about all I thought about. I discussed it with my doctor several times and made it abundantly clear that I didn't want an episiotomy unless absolutely neccessary. Unfortunately, a different dr in the practice delivered my son. She said that his heartrate was too low and gave me an episiotomy to deliver him faster. I would say that you never want to have an episiotomy, as it makes tearing much worse than if you simply let it happen naturally. I didn't feel the cut or the tear that followed until a few days later when I was at home. The amount of pressure you feel when you're in labor and pushing is overwhelming and kind of blocks any pain from tearing. All I felt was an incredible release of pressure as he was delivered. Once I was at home, I was in quite a bit more pain for a few days. It was difficult to sit and I was actually told to lay as much as possible to avoid putting any pressure on that area. I had a severe 4th degree tear b/c of the episiotomy. I cried everyday for about 2 weeks b/c I was convinced that my body would never be the same as it used to be and that I would never want to have sex again. I had done perineal massage for weeks beforehand but that was inconsequential b/c the the epi. It took 9 weeks before I was ready to have sex and the first few times weren't great, but my husband was very patient and helped me through it. It's been 4 months now since my son was born and things are completely back to normal and probably have been for about 3 or 4 weeks. I think my case was a lot more severe than most (I actually had to have surgery 7 days after the birth to repair the episiotomy b/c it wasn't stitched back up well enough) and I know my recovery was affected by that. As bad as things were, though, I would do it again.
  • I was terrified of tearing, too, and I didn't. I did practice perineal massage a few times toward the end, but not regularly. My labor was pretty slow, she decended slowly and I pushed for an hour before my daughter was born and I think that that helped a lot! I also provided my own perineal support when her head was coming out.

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