Natural Birth

Question about tearing.

This is my first pregnancy and since I'm half way through, I've started thinking about the actual delivery. 

Since I'm going with a midwife, I'm having an all natural birth and considering a water birth. I've heard that will lessen the chances of a tear. Is this true? And if I do tear, how bad can I expect?  I read somewhere that a lot of FTM's experience third and fourth degree lacerations. Is there any truth to that?  

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Re: Question about tearing.

  • I only had a first degree tear for my waterbirth. I didn't even need stitches and it healed really quickly.
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  • I can't speak to a waterbirth, but with my hospital birth, I did not tear.
  • I''ve heard that waterbirths reduce tearing too, and I didn't tear at all in my waterbirth. I don't think it's true that FTMs usually get third or fourth degree tears.
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  • Yes, water birth is great for preventing tearing. 

    Everyone is different, there is no way of knowing ahead of time what's going to happen.  3rd and 4th degree tears are certainly not the norm for anyone.  It happens, but it's not normal.  

    There are other things you can do to help prevent tearing such as supporting the perineum during pushing/crowning, perineal massage with oil, warm compresses, pushing in more optimal positions than on your back, mother-directed pushing, controlled pushing at crowing.  Considering these are things that midwives typically do that's why your chances of having a major tear with a midwife tend to be less.  

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  • I too have heard water birth helps with tearing. 

     I had two dry births and had 2nd degree tears with both.  I did not find the recoveries a big deal at all.  Just do the ice packs, witch hazel tuck pads and don't look, lol.



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  • I labored in the tub and started to push while in the tub.  I transitioned to the bed to delivery my LO.  I ended up with a second degree tear because my LO had a nuchal hand.  My OB tried to prevent me from tearing my giving a perineum message and it probably helped me not have a third tear.  Honestly, I would have torn just as bad if I was still in the tub. 
  • I'm an L&D RN in a pretty "medicalized" facility, and no, 3rd and 4th degree tears are not "normal".  They happen, but I bet in far over a thousand vaginal births that I've seen, I've seen maybe a dozen or so 3rd degree tears, and one or two 4th degree.  Definitely not the norm, and that's with OBs, a lot of high risk, and a lot of epidurals.
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  • I think those statistics may be for moms with epidurals on their backs. Natural birthers can tear but the chances of it happening and being severe are really low. Massage the perineum, let baby's head stretch the perineum while pushing if you can and don't push on your back.

    I tore with my epidural babies (first two births) and didn't tear with my next two births (natural ones) and I think being off my back and feeling as I pushed really had a lot to do with preventing tearing.
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  • I don't think there is any way to predict whether you will or won't tear, or to what degree you may tear.  I don't think the chance increases or decreases whether it's your first birth or your tenth.  I have a friend who delivered naturally twice with no tearing, and she had 8 and 9lb babies.  I delivered naturally twice and both times had a second degree tear.  I can honestly say I was not aware of the tear as it was happening, I had to ask after if I had torn.  Also, my second was almost 2lbs. bigger than my first, and I had the same tear and I can honestly say pushing out a bigger baby did not feel all that different.  I have heard that water births can reduce the likelihood of tearing, but I don't know the statistics on that.  
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  • My first birth was a water birth - DS was 7lb 15 oz and I pushed for an hour- and had an itty bitty tear, only 1 stitch. I didn't tear at all with DD or DS2 (another water birth). 

     A womans chance of a really bad tear like you mentioned go up way more with the use of episiotomy; I don't think it's common at all to tear that bad naturally.   

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  • imagealanap:
    I can't speak to a waterbirth, but with my hospital birth, I did not tear.

    this for me, too. 

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  • DD1 I laboured in the tub, but pushed her out on the bed, on my back. 9lbs. Needed 2 stitches, which were quick and easy to heal.

    DD2 Didn't labour in the tub at all. 10lbs 2 oz. No stitches. 

    My understanding is that waterbirths definitely reduce tearing, but there are other issues, like baby's position, and if you PUSH vs pushing gently and easing baby out, and a lot of it is just luck and circumstance. 

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  • I'm planning a waterbirth this time in hopes of preventing another tear. I had a 2nd degree with my first - he was under 7 pounds but I pushed only a few times on my back and that is what I believe did the damage. Having a midwife who will help you control your pushing and being in the correct position should make a huge difference for you. But as others said, there's no way to know what to expect. 
  • Thank you all for your answers! They have certainly helped. 
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  • imagevintagejjane:
    I only had a first degree tear for my waterbirth. I didn't even need stitches and it healed really quickly.

    This, exactly for me too. I haven't read the other responses yet so I'm not sure if someone's mentioned this but my MW was very good about doing perineal massage during pushing to decrease my chances of a tear. That probably helped a lot as did the water.

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  • I know that three of the first time moms from my birth class last time (me included) all had 2nd degree tears. The rest either had c-sections or no tearing at all. I had it worst since my family has a history of vaginal prolapse and even so, it's not awful. 
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  • i had my first 2 naturally, no water births, and I got 2nd degree tears both times. 
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