Any tearing with a home/water birth?

blonddnyc · February 2012

One of the things that concerns me most is traring or having to have an epi - i have always wanted a water birth and it sounds like there isnt much tearing because the water softens it up - is this true based on your experience? What about a natural birth with a midwife whether at home or in a hospital is there still the chance of tearing or having an epi?

annabelle.27 · February 2012

I had a home waterbirth and no tearing. This was something I was really afraid of as well.

I have read this study which looked at 13,000 births and compared outcomes between homebirths with midwife, hospital births with midwife, and physician-attended births in hospital. Midwife-attended homebirths had the lowest rates of tearing or episiotomies when compared to hospital births attended by either a midwife or a physician (and other improved outcomes as well).

https://www.cmaj.ca/content/181/6-7/377.full.pdf+html

That being said, there is always a chance of tearing or having an episiotomy. You cannot eliminate that risk, unfortunately.

flyer23 · February 2012

I tore at both my births. DD = OB-attended hospital birth, DS = midwife-attended waterbirth at home.

FWIW, I was terrified of tearing, but it was no big deal. With DD, I took prescription-strength ibuprofen for maybe 2 days after the birth. They gave me a vicodin prescription but I never felt the need to fill it. With DS, I didn't need any sort of pain medication after the birth. Obviously, both tears healed up fine, or I wouldn't be pregnant again Wink

As for epi's, they're typically an option if you're in a hospital (whether OB-attended or midwife-attended), but not at home -- unless you transfer to the hospital to get one, of course.

Sawyerplus1 · February 2012

I think there's always a chance of tearing, no matter what. But there are some things that can be done to help prevent it. On the other hand, you can do all those things but have LO come really fast and still tear.

I had a water birth with DS and had a small tear (only a couple of stitches). I had a hospital birth with DD and had no tearing at all.

iris427 · February 2012

You can't determine whether something like this is true based on individual experiences. There will always be people whose experiences will be unusual. I am not sure if water birth itself reduces tearing, although it would make sense that the hot water would help tissues stretch. But the midwifery model of care itself reduces the rate of high order tears.

I had a water birth and a first degree tear. Any time you are delivering vaginally there is a chance that you will tear. By epi, are you asking about episiotomies? If you have a midwife, she will probably do episiotomies rarely or never.

august8080 · February 2012

I had a med-free birth in a hospital with an OB and no tearing (9.b, 8 oz baby with a >99th% head) so it's really possibly in any situation.

I credit a couple of things:

-his position-he was rotated face down, as is ideal

-MY position--I delivered his head while on my hands and knees which opens your pelvic area at least 30% more than the traditional pushing position of laying back and pulling your legs up

-the fact that I didn't "push" but instead did what hypnobirthing calls "laboring down". THis allowed the baby and my body to do the work at the correct pace to allow stretching to occur without tearing.

tokenhoser · February 2012

There are a lot of factors that go into a tear or no tear. My baby came out occiput posterior, and even after 2 hours of pushing he didn't turn. I have a feeling that not being in water wasn't the reason I tore - he just wasn't going to fit in the position he was in, and nothing was moving him (I was in the "correct" hands and knee position for most of the 5 hours leading up to the birth).

It happens. It's not that big of a deal. The freezing to get the stitches was worse than it actually happening.

PBP2002 · February 2012

I had a water birth at a hospital and ended up with a second degree tear. I can't attribute it to any one thing, though... It just happens (I pushed for three hours, so that should have helped, but DS was 8lb 9oz, so that probably didn't help)

KateLouise · February 2012

I agree with pp that said it's hard to pin point any pattern from individual experiences.

DD1 was 9 pounds hospital birth with midwife. Laboured for a while in the tub, but delivered on land. Pushed for an hour and a half. 2 stitches.

DD2 10 pounds 2 oz. Unexpected home birth. Born in 6 very quick pushes, no stitches some light grazing.

Both were born with me pushing on my back, which is meant to increase the risk of tearing. So who knows.

I also agree with pp that if you have minor tearing it's not a big deal. Sure it stings a bit to pee, but the tissue heals quickly.

Obviously some people do tear very badly, and it is very uncomfortable for them but I'm not sure it's something you can predict or entirely avoid if that's something your body is going to do.

kali55 · February 2012

I went natural and at home and wanted a water birth however I had to do it on my bed as my little guy was taking his time in the birth canal. I pushed for just under three hours and my midwife massaged the area the entire time which I think was the reason I escaped tearing.

julyjennifer · February 2012

I had a small tear with my home water birth that did not require any stitches.

For me, I was not very worried about whether I tore. It sounded awful to me pre-babies, but afterwards I wasn't worried about it, because I never felt it in the moment and had bigger things to think about, like my baby. I had a 2nd degree tear with my hospital birth and it was not a big deal for me.

Here's a midwife blog post that argues that "perineal tearing is a normal part of birth; and that the body will heal itself."

https://midwifethinking.com/2010/08/07/perineal-protectors/

pinksweetpea2 · February 2012

I had a 3rd degree tear with my first who was 9 lbs 15 oz. I always thought it was because of her size, however a week ago I gave birth again in the water at home to a 10 lb 10 oz baby and didn't tear at all...and this labor was MUCH faster and intense. I was shocked to say the least.

I am not going to lie to you- the tear I had was rough, but I think what made it really hard was because I assumed I wouldn't tear at all because I was in the water. It just doesn't always work that way and although there are things you can do to prevent it, sometimes it happens anyway. It is better to accept it as part of the birth process

In the end I healed and as you can see I went on to do it again.

I don't think my MW has ever performed an episiotomy. Tearing is pretty much always better. Episiotomies are SO outdated and barbaric IMO.

LindseyJW · February 2012

there is no magic formula that if you follow you absolutely won't tear. you can prepare for an unmedicated birth, do all the recommended things to reduce the risk of tearing and still tear. i did. (except perineal massage, i didn't do that and wish i had). i had a water birth, a midwife and no epidural and i still had a nasty tear.

positioning during birth can help, preparing the perineum with massage prenatally can help, going through the birthing phase slowly can help, "pushing" naturally with mother-directed effort rather than on a forced count to ten can help.

i assume you mean episiotomy when you say "epi"? most of the time on this board, epi means epidural!

some MWs will cut an episiotomy, but most will not. especially at a homebirth. if this is something you don't want, you just need to make that clear.

Any tearing with a home/water birth?

Re: Any tearing with a home/water birth?

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