someone please make me feel better about this....

svenskalamb13

i definitely plan on having NB but i have one giant fear: tearing.

I am super afraid of tearing down there and getting stitches. The thought just freaks me out!

someone, please talk me out of this fear, being a FTM and being very confident going into labor and giving birth other than this one thing....

blonddnyc

I will be a FTM too and also afraid of tearing (one of my greatest fears!) and due to that, I have added several thins into my birthplan, after many months of reading and research. So here it goes:

- Labor in water (tub or shower) this will soften the perenium and allow it to stretch easier. Think of how much more elastic your skin is when its wet or in water versus when its dry. For this reason, waterbirth is my first choice but its very hard to find in a hospital setting, so I plan to be in water for as much as possible, either in shower or tub.

- Continue to oil the perenium during labor. I have heard of midwives who do this as common practice, but I couldnt imagine an OB doing it. So maybe your partner or doula could do it for you. If the perenium is soft and oiled, there is far less chance of tearing

- I read in Marsden Wagner's book "Born in the USA" that it is better to allow a natural tear to occur rather then get an episiotomy. I read this book about a year ago, so by now I have forgotten the reasons why, but I did write that in my birthplan. No episiotimies - let it tear if its gonna happen. I think this has something to do with how it heals.

 

I recently had a friend give birth and she suffered a 4th degree tear (which is basically from vagina to anus) definatly i want to avoid this as much as possible. She did not have a midwife or a doula, and did not have any water in her labor. Ask your provider what their episiotimy rate is and how often their natural birth clients experience tearing, and what they reccommend for preventing it.

Hope that helps! Do your reasearch, there are alot of positive stories out there that show preventing a tear or episiotomy is totally possible!

FyreFlyeRush

There's really nothing I can say to calm to you. Some women tear, some don't. Even with perineal massages, etc. I was terrified of tearing and didn't want an episotomy. But, she came SO fast, there wasn't time to adjust. I tore slightly upwars. So, the OB did a quick episotomy, 3rd degree. I didn't care. I didn't even feel it. 

Healing wasn't bad. I couldn't pee without my dear friend, the sitz bath, but that went away in less than a week. I used peripacks for another 2, I think.  Oh, I also recommend against a donut pillow, as that ends up putting pressure on the site. Ice packs FTMFW. Good luck!! I hope you don't tear, but I'd you do, it really isn't as bad as it sounds. 

Celyn

Some of the best ways to avoid tearing are: 

- don't get an epidural (which helps you avoid pushing harder than you need to)

- ask your caregiver to support your perineum with a warm compress (you'd think that'd be standard practice, but it doesn't always happen) 

- listen to your body and the person catching/supporting your perineum.  Allow the perineum to stretch against the gentle pressure of the baby instead of pushing once the body is crowing.  Use nudges full lungs or a cough or simply wait for your uterus to do the work.

- don't be spread eagle on your back. Being on hands and knees or a squat (again, don't actively push from a squat, let gravity and your uterus expel the baby)

- lastly, try to clear your fear of tearing.  Talk about it and do a fear cleansing exercise (like this: https://www.selfgrowth.com/articles/you-are-never-your-fear). If it happens, it happens, and chance are if you do the previous things that it won't be severe.  Tensing up with fear while pushing will make it much hard for the baby to come down. 

 

HTH! 

 

StefandTodd

Love the PP's suggestions.  I've heard conflicting info about perennial massage, so despite my intense fear of tearing, I refused to do it.

Our Bradley classes really emphasized squatting to help stretch the perineum naturally.  I remember asking in Bradley why, since birth is such a totally natural thing that our bodies are made to do, do so many women tear.  And one of the things my teacher talked about was our more recent steering away from squatting (i.e. women used to squat to use the bathroom, squat around the fire to cook, etc), so that stuck with me and I would squat all.the.time. while pregnant.

And so...I had a 2nd degree tear.  And I know everyone says this and it's hard to believe (b/c I was REALLY afraid of tearing too, I promise), but it really, really was no big deal.  Really, truly.  Prepare the best you can for your birth and to avoid tearing, but then try to not let it worry or scare you.  IF it does happen, I can almost guarantee you'll someday be telling someone else how scared you were of it, but how it really wasn't as bad as you imagined it would be.

Good luck!!  

nosoup4u

I had a second degree tear, and it wasn't that bad. It took a few weeks to heal, but it wasn't horribly painful, and I didn't know I had torn after he was born. There's not a huge amount you can do to prevent it, quite honestly. 

tokenhoser

I did everything "right", but my baby was occiput posterior and wouldn't turn (again, despite doing everything "right" and being on hands and knees for about 6 hours of my labour). I ended up with a third degree tear.

I had to ask my doctor if I tore - I didn't know. It didn't hurt when it happened. It did hurt getting the freezing injected (that was the worst part), and getting the stitches wasn't fun but didn't hurt. The healing took 2 or 3 weeks, but it gave me an excuse to hand the baby off and take 10 minutes to myself twice a day. The doctor told me to go soak my stitches in the bath that often, so I'd read a magazine and chill out. 

It has healed well. I had a little pain with sex for a while, but that has improved and isn't an issue any more. 

So do what you can to avoid it, but know that if it happens it isn't as bad as it sounds. I still plan to have another baby.

WildcatPrincess

hibiscus29:

Thank you for posting this!  I am actually more afraid of the tearing and stitches for some reason than i am the actual labor.  I don't know what it is about needles and shots, but they make me extremely nervous.

If it makes you feel any better I haven't seen any of the needles either time and with that baby crying on your chest your focus is totally not down there. I felt a pinch with the local being injected, but that was it. Everything was kind of burning anyway, so in the long run it wasn't a big deal.

redheadinlove

I labored in the tub on all fours. I had a pretty quick labor and I had no tears to the perineum but I did have some about a centimeter from my clit and right near my vaginal opening. It's not as bad as I suspect you're fearing. The ones by my clit terrified me and hurt like crazy, but I was able to push baby's head down to relieve some pressure. I was given a shot of Novocaine for the stitches and she would give me a little more if I told her I could feel any pain, not just pressure. I'm a week post partum and for the most part am not bothered by my stitches. The only times it has bothered me was when one came out a little early and I still had a raw spot and now the ones by my clitoris are almost fully healed and the stitch hasn't dissolved so it's just an odd feeling. Not painful though. I promise, if you make it through unmedicated labor, the tears and stitches won't compare!

svenskalamb13

hibiscus29:

Thank you for posting this!  I am actually more afraid of the tearing and stitches for some reason than i am the actual labor.  I don't know what it is about needles and shots, but they make me extremely nervous.

this is exactly why i posted i feel the same way

theladyjess

I had a 2nd degree tear but didn't feel it when it happened.  All I felt when my dr was repairing the tear was a bit of tugging (she used a local anestethic).  I will admit that I had some discomfort while healing but the hosptial gave me ice packs to use for the first 24 hours and Dermaplast spray.  Tucks or witch hazel pads also help soothe the area.

Alliebooberz

I had a NB and tore. I think I tore because I pushed him out so fast. But really, everything healed and in the grand scheme of things, it's not even something I think about. It goes by so fast, don't be afraid. It's better to tear IMHO than to be cut. 

BLuvsE

I read in Marsden Wagner's book "Born in the USA" that it is better to allow a natural tear to occur rather then get an episiotomy. I read this book about a year ago, so by now I have forgotten the reasons why, but I did write that in my birthplan. No episiotimies - let it tear if its gonna happen. I think this has something to do with how it heals.

-lurker here-

The reason for this is that when your skin tears naturally, the tear happens along the borders of your skin cells. If it is cut, the incision goes through the cells instead of around them. I imagine it like the a brick wall crumbling - naturally, it would fall apart where the mortar is, but if someone were to just cut a straight line, it would go through the bricks. Because the individual cells are not damaged, and not just the 'mortar' between them, a natural tear heals faster.

Also, most tears are so small they only require 1-2 stitches, if any at all. But with an episiotomy, the cut is almost always bigger than necessary requiring more stitches, and more healing time.

Archhig

Thank you so much for posting this! I have been so scared about tearing out of everything delivery! this gave me alot more ideas of how to prepare in hopes of prevention.

mAnYaSha

LOL

I guess all of us have our own dominant fears about birth. I was afraid of pooping on the table. I never even though of tearing.

I am a minority here, but looking back I wish I got cut right away, but then again, I was in the hospital with pitocin and no massage/stretching/warming up and so on. I also think that I or someone else put counter pressure on the tissue from the beginning, I really feel like if I had those things done it would have gone differently.

I listened to the nurse (who is now my midwife) and tore in a several placed, none of them going down. It did not hurt when happened, only when I continued to push and created pressure on the tears. I asked for someone to apply counter pressure in those spots and it was fine. I finally gave up and asked to be cut. Then DS was born fast.

Everyone is different and not everyone has ridiculously strong tissue and large headed babies. I got a LOT of stiches for the tears and the cut and it took me a long time to heal. In the moment it will not matter as much as it does now that you have time to contemplate on it. Even with my not so great experience  the first time I am not afraid this time around. It's the unknown that is scary. 

Use your nervous energy to research everyone on stretching and softening the tissue. You will do great

mamaloves

These are great responses/advice for trying to avoid tearing. I wish I had given myself perineum massages during the last month of my pregnancy - I have no excuse for why I didn't do them. But I did have a very supportive OB who did a TON of perineum massage during my labor and delivery, but to no avail. She knew I did not want an episiotomy and truly seemed to give it her best effort for quite a long time. Finally she asked if she could go ahead with the episiotomy and I agreed, baby was out with the next push. I am not pro-episiotomy, just telling my experience.

I had 3rd degree tears and an episiotomy (I'll never know which came first, I tend to blame the episiotomy for the tearing but who knows). I did not feel either when they happened, but getting stitched up after hurt and took 20 minutes, ugh. Healing took a few weeks but nothing unmanagable -- just a lot of TLC. (ice packs, tucks pads, sitz baths, etc). Also, my baby had a very large (perecentile-wise) and round head (he was breech for months, not head-down until the final 2 weeks of pregnancy so maybe if he were more cone-headed it would have been better).

Mrs.MauiBride24

I couldn't tell when it was happening and had to ask my MD afterwards (second degree).  She did warm washcloth compresses and I think used KY as I was crowning. 

Ask your OB their stance on episiotomies.  I was plesantly surprised to hear that my OB and her practice don't do them.  She said she could count on one hand how many she'd done in the past two years. 

One comparison that really helped me see why it's better to tear naturally than get an episiotomy is to think of a t-shirt.  If you were to try to rip your t-shirt off, it'd be hard to do.  Now think about cutting a notch in the t-shirt and THEN ripping it off.  Easy peasy and you can rip it much further with the cut than without.  And you're likely to tear further than the cut. 

Also, circulation-wise - think about sitting on your hand or foot for a long time til it was numb, then getting a cut on it.  The pressure the baby's head puts on you numbs that area from blood flow, so it's not like you're just sitting there and tear.   

Honestly, there was so much going on and I was SO ready to get him out that I wasn't even thinking about it.  (Pushed for almost 2 hours).

I didn't feel the shot to numb me before stitches (that was the part I was most scared of).  Healed just fine.  Loved the ice packs and the spray.  Everything was so sore, it was hard for me to tell what was what but I had a great recovery.  And don't look with a mirror! 

JoyfulW&M

A few tips that could either prevent or make the tear smaller.

a) I agree with the oil massage if you don't want or can't be in water, you can actually start these now, use a little personal lub or oil, olive oil or coconut oil works just fine, any edible oil will work. Use your thumb and place it about an inch inside and gently press down until it is just uncomfortable while sliding your thumb side to side, about 5 minutes a day should be good.

b) Counter pressure during crowning, basically place your hand on your perineum and press with your fingers where ever the pain is the sharpest

c) when the head crowns push SLOWLY, take your time to crown, yes it hurts but it will help prevent tears.

d) remember it is better to tear then to be cut, less pain, quicker recovery, stronger scar, less likely to tear later, less likely for long term pain during sex.

e) one last thing is if the tear is small you can go without stitches and just keep your legs together and no squatting for 2-3  weeks and your good. I had stitches with my first, and the second was such a small tear I was given the option and chose to forgo the stitches.

Tigerlilym15

svenskalamb13:

hibiscus29:

Thank you for posting this!  I am actually more afraid of the tearing and stitches for some reason than i am the actual labor.  I don't know what it is about needles and shots, but they make me extremely nervous.

this is exactly why i posted i feel the same way

You have a ton of good advice, so I won't add to that but I did want to comment. I was really afraid of tearing too. I told my mw and she coached me through a lot of things to help reduce it. She told me she would coach me during pushing which would help reduce the risk of a tear when crowing.

In the end, I had a second degree tear. She told me later that I didn't tear during crowning but when his body came out he turned kind of funny and his shoulder tore me. He also got stuck so they were having me push really hard which didn't help.

After my son was born, I hardly felt a thing down there. My mw told me she was going to give me a shot but I never saw it and I hardly felt it. I didn't really feel the stitches either. You will be so overwhelmed with meeting your baby you won't even care what is happening to your vagina anymore. Recovery was a little harder because of the tear, but the shot was nothing.

jinnymb

I tore with both my boys.  The first one I had a faulty epi so I felt a lot and the second one I had med-free.  I did not feel it at all with either.  It burned a lot when their heads emerged but I did not feel any actual tearing (which I could see why that would freak you out).  The burning lasts a few short seconds compared to the rest of the birth process.

The shot for local was quick and I was very distracted during both set of stitches I can barely remember it.  The recovery was easy for both.  I used the water bottle and sitz bath religiously and honestly that was the least of my recovery for both boys.  I tried not to push when they said not to, but I was more concerned with getting the baby out of me, lol.

 I know it sounds scary but not too bad, good luck with your med-free birth!!