Epidural reducing risk of tearing?

baly3225 · October 2014

After speaking with my dr about being nervous about tearing, she told me that women who get epidurals tend to not tear as much. She's not the type of dr to push an epidural and is behind whatever method of pain management I choose. Do you actually tear less with an epidural?

RayRay007 · October 2014

Everything I have ever read or heard about the relationship bw epi and tearing is that if anything, you are more likely to tear with an epi because you can't feel what you are doing. Without an epi you can feel and control your pushing through that final phase and slowly stretch your perineum and have a lower risk of tearing.

Maebb · October 2014

I also don't know. I had a 2nd degree tear with an epidural, and I've known people med-free who didn't tear and basically every combination. I would make your epidural decision completely independent of your thoughts or fears about tearing.

Amstreagle · October 2014

Yeah I don't know either. I had an epidural and still tore but if I think about it it might make sense that a woman without an epidural may try to push harder and get it over with because they can feel everything where a woman with an epidural may take more time allowing the area to stretch.
I'm not a doctor though so don't take my word for it.

taahira · October 2014

I had a epi with my first and had 3rd degree tear. With my 2nd baby. I had a completely natural birth and only required 4 stitches. I'm unsure if your doctor is right in her statement.

ScarlettsMommy0515 · October 2014

I had an epidural and my tear was awful! I've only heard the opposite of what your doctor said.

marriedinaugust · October 2014

RayRay007 said:

Everything I have ever read or heard about the relationship bw epi and tearing is that if anything, you are more likely to tear with an epi because you can't feel what you are doing. Without an epi you can feel and control your pushing through that final phase and slowly stretch your perineum and have a lower risk of tearing.

This.

ashiscute · October 2014

mjreilly2 said:

I have seen people with third degree tears that had epidurals and that went natural. The same goes with no tearing at all. It has a lot to do with progression of labor, size of baby/pelvis, positioning, and pushing, among other things. They can turn down the epidural when you start pushing if you want to feel more or are having troubles with pushing properly.

This. Just because you have an epidural doesn't mean you can't feel what you are doing. I've had 2 epidurals and could still feel 100% when to push and when not to. Epidurals do not affect everyone in the same way. I also tore with my epidurals but it wasn't bad.

Dani0329 · October 2014

In birthing class, they told us that an epidural increases chance of tearing.

AthenaNabi · October 2014

This is not true. Having an epidural and/or patocin increase your chances of tearing. When you receive an epidural your body stops releasing all the natural chemicals it would normally release during labor, including the chemical that helps you to loosen up and stretch down there. On a side note, there are some statistics that suggest that midwife births have less tearing than doctor assisted births.

minirella · October 2014

I had an epi and had a 2nd degree tear.

MrsDL · October 2014

AthenaNabi said:

This is not true. Having an epidural and/or patocin increase your chances of tearing. When you receive an epidural your body stops releasing all the natural chemicals it would normally release during labor, including the chemical that helps you to loosen up and stretch down there. On a side note, there are some statistics that suggest that midwife births have less tearing than doctor assisted births.

Yes - I would like to see a source for this as well, it seems to contradict scientific logic in that epidurals/spinal are regional anesthetics that actually don't cross the blood stream. "hormones" and "chemicals" being released by the body during labor is a systemic occurrence and starts long before labor. What you say makes no sense, nerves being numbed so you don't feel pain (or as much) regionally has nothing to do with, for example, relaxin (hormone partly responsible for pelvis stretching, heartburn, cervical dilation) which is produced by corpus luteum in the ovaries and placenta during pregnancy. An epidural does not interfere with the function of the placenta or ovaries (or glands that also produce labor hormones).

baly3225 · October 2014

Thanks - being a FTM I didn't know if you had the decision to push when you wanted to or basically had to listen to the dr/nurse when they tell you to. Did any nurses or Drs still have you push when they thought you should or were they okay with you pushing when you felt the need? (That is after you're fully effaced and dilated)

minirella · October 2014

My epi was so good that I could not feel anything even fully effaced/dilated. My nurse watched the monitor and told me when I was contracting and to push. I didn't have any sensation or need to push due to the epi so she had to guide me.

AthenaNabi · October 2014

I had a really good website that broke it all down really well, but that was when I did all my research like 6 months ago, so now, of coarse i can't find it. After to doing a quick search I did find this website; https://www.storknet.com/cubbies/childbirth/epiduralprosandcons.htm which for sure doesn't go into it and break it down as well as the other source I used, but it does talk about the increased risk of tearing and mentions that an epidural does stop the normal release of Oxycontin. However I did discuss all this with my midwife and she didn't object to any of it, so Im pretty sure it's generally excepted.

AthenaNabi · October 2014

I think it is also discussed in the documentary The Business of Being Born which you can stream on Netflix.

lesliegolem · October 2014

I had an epidural and got a second degree tear which was awful. It healed funny so it took months and the Dr removing scar tissue to get back to normal.

I loved my epidural, it just took the edge of the pain. I still felt everything. What didn't help me was that I pushed her out too quickly. I'm not sure if pushing on the Dr's command or on your own would affect things or not? I pushed on the Dr's command and things were going fine. My Dr then decided to try this thing where she put a bar over my bed where a towel hangs off the bar. When I pushed I could use the towel to pull (think it's called the "tug of war" or just "towel pull") Holy crap my baby practically flew out lol! They didn't have time to finish prepping because they thought it would take longer. So I think how quick she came during that phase is what made me tear. I'm going to try perineal massage this time hopefully that will help.

sunnysunsun · October 2014

What I always thought played a big part in tears was the position you deliver in. You want the tailbone/coccyx to be as open as possible with the combination of pushing to allow the perineum to stretch.

I could be wrong, but I have read it in a few different birth books.

Dani0329 · October 2014

You could labor down once you reach 10 cm so you can feel when pushing will be most effective. I got
An epidural at 8 cm, but never lost the sensation of pressure on the right side and could feel it build, I asked nursing if they could see it on the monitor and they would respond and let me push as I see fit.

I had two teeny tiny tears, and very little pain afterward.

Beevol · October 2014

I have not seen any statistics regarding epidurals and tearing. I had an epidural and I tore a bit and needed a couple stitches (mostly because I only pushed twice and she just popped out, so I'm not complaining). I was really glad I had the epidural because I think I would have torn anyway and at least I didn't feel it or feel my OB stitching me up after.

If you are worried about tearing, the only thing I've heard that helps is perineal massage.

soulcupcake · October 2014

You can tear with or without epidural analgesia. What plays a bigger factor is how the second stage is managed. Mother-directed pushing, spontaneous pushing, gives the mom more control, because she's pushing with her natural urge. Directed pushing and pushing in the lithotomy can lead to a prolonged and unsuccessful second stage, as well as malpositioning.

I had an unnecessary episiotomy with my first to "make room" for her because she was suspected to be LGA. It shouldn't have been done. She'd have been born fine without it.

I had a labial laceration with my second due to her rapid descent and birth, and the same with my fourth, labial split and skid mark from his extremely precipitous birth.

In my case, tearing on my own is a result of their rapid births, and I'm of the "if it happens, it happens" mindset. I healed very quickly from my tears.

suncake · October 2014

No tear with epi. But I think the trick is to sit a few mins with baby crowning. Stretching some before just shoving LO out. This is not advice from a medical professional. Just my experience.

EricaOO · October 2014

Lurking - Had an epidural and 2nd degree tear.

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