My first was born via c-section (so obviously no perineum tear) and I didn't tear with my second (VBAC). I had an epidural and even though I could feel the contractions to push, I wasn't in real pain, and wonder if maybe that is why I was able to have slower/more controlled pushes (since not driver by intense pain).
My sister who had all her 3 children drug free, tore each time, and she claims that when you get to the pushing, you are so ready to be done that you tend to push harder and not really have to will/desire/energy to take it slowly.
I'm sure there is no rule to it and that women tear/not tear with and without epidurals, depending mostly on baby's size/head circumference....etc. But as I am considering going drug-free this time, I wanted to hear what you guys thought.
:-)
Re: Wondering about a possible correlation between epidural and tearing?
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I have had 2nd degree tears with both of mine. I had an epi with both.
The first baby was a preemie but required a vacuum extraction that caused it to be super fast and furious. She was only 5 pounds 1 ounce but I still had tearing.
My second baby was full term and 9 pounds 11 ounces. It was controlled and I was pushing effectively but he was HUGE.
I would think that baby's size, your body, and whether you need any intervention have more to do with tearing than anything else. If you google search journal articles you might be able to find a study on the correlation.
this says there is more than 3 times the percentage of tears with an epidural
ETA. Also, IMO I don't think you're going to get a very good idea of what the general consensus is. Generally what I've found, is that people only take the time to answer if they really agree or disagree. You should post a poll for second time moms, you might get a better idea of actual answers because more people will respond.
That's just what I think though.
I had an epidural with my DS and I was given an episiotomy and I ripped on top of it. Not fun. They were in a rush to get him out though, his heart rate dropped from 150 to 73, so this is why they gave me an episiotomy.
We actually just talked about this in our childbirth class today (hypnobirthing). She said tearing is generally a 50/50 chance, but that she thinks more tearing happens with epi's because you can't feel how hard you are pushing vs natural when you can back off a bit if it feels like too much - with the hypnobirthing, they also don't have you hold your breath, so that helps decrease the tearing i would think..lets your baby come down more gently so you're not pushing as hard against the pelvic floor.
More importantly, the teacher said kegels and doing squats to stretch our your hips is helpful to prevent tears. Like have your DH hold your hands while you squat down to the floor and rock back and forth a bit, and eventually your hips will stretch out a bit and give more room for the baby.
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Really? I am not a dr. but in all the things I have read about pros and cons of epidurals and the paper you sign at the hospital telling you risks of getting an epidural nowhere does it say 95% chance of tearing. This actually seems made up to me. Like I said I am no dr. I know why i tore and it has to do with the way my body is built. Not the fact I chose to have my pelvic area and legs numbed. I am pretty positive on this.
I've had one birth with an epi and one naturally - no tearing with either. It had nothing to do with the medication or lack thereof, but had everything to do with a wonderful MW who coached me through pushing and helped me breathe through it so I wouldn't tear. She also did a lot massaging down there to help stretch me out.
My babies were 7 lb. 10 oz. and 8 lb. 11 oz. - so size doesn't really have anything to do with whether or not you will tear IMO.
I think this is the general theory about epidurals and tearing. Without one (usually) your body will tell you what to do. Push more, push less, this position, that, etc.
I wish I could find some studies on it.
I had an epi and tore. DS had shoulder dystocia, so they did do an episiotomy, and I had a 3rd degree tear on top of that. Not sure what it would have been like had he not had the dystocia.
I can see a correlation between epidurals and pushing less effectively. Pushing less effectively may mean a woman is tightening up instead of letting her tissues relax, which is going to mean a higher likelihood of tearing too.
One thing that really helped me to learn when pregnant with my DS was that the majority of the force that a baby is pushed out with is actually from the muscles of your uterus, not your pushing. You can't "push" with your uterine muscles - your body does it on its own. The pushing you do, or try to do, is only about 30% of the force acting against your baby, and your uterus is doing about 70%.
If you're pushing ineffectively, or can't feel what you're doing, you may just be tensing up against the work your uterus is doing.
Yeah, I'm going to need some support to this asinine statement.
Thank you. This was my point earlier. Foolishness really.
My sister has had 3 babies, all without an epidural.
Baby #1 - 6 lbs 8 oz and a tear (I have no idea how big, but required stiches)
Baby #2 - 6 lbs 11 oz and a tear (again, I don't know how big, but again, needed stiches)
Baby #3 - 8 lbz 10 oz and no tears, but a different doctor who coached her through her pushing.
I have had one baby, with an epidural
Baby #1 - 6 lbs 10 oz and a small 2nd degree tear that needed like 4 stiches I think. I could feel the urge to push though and knew when to push and when not to.
I don't think you can say that epidurals cause tearing. I think it's more the doctor and your pushing method.
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I think it probably matters more to have a skilled practitioner who can do perineal massage and help you push effectively (although I think an epidural could easily make you a less effective pusher in terms of not being able to feel as well what your body is needing to do).
I had a tiny (not even 1st degree tear with kiddo) - he was 8lb6oz with a 95th percentile head. No epi. I think my midwife made all the difference!
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