Epidural and tearing

plumpous · October 2015

Do you think there's a connection between having the epidural and tearing? I read a lot of posts here and looks like a lot of you tore quite severely. I count my lucky stars because I didn't, apart from a minor episiotomy. I myself didn't get the epidural due to timing and I know most women get it so I thought it might be related. Like because your sensation down below is numbed the whole pushing gets out of sync from what's natural to your body and you may also not feel that you're tearing.
I ask this both out of curiosity but also because I thought that for the next pregnancy I'd take the epidural but I'm nervous about it. It scares me more than going med free after I successfully delivered that way the first time.

jburrell13 · October 2015

I tore because my doctor barely made it in time baby was already crowning so episiotomy wasn't an option

plumpous · October 2015

Gosh... Why are doctors so absent in the process. Mine was barely there as well and pp saw me for 2 minutes two days later.

tracij12 · October 2015

Interesting question. I have had 2 c-sections so have no point of reference, but it does seem like there was a lot more tearing in this group than when I had DD1. Was wondering if more ladies were just mentioning it this time around.

lindsay897 · October 2015

I had an unmedicated water birth and still had a 2nd degree perineal tear and my labia tore in half. My baby was only 6lbs 7oz but he came out fast. When I felt the urge to push it was so strong and intense that I couldn't take it slow and allow my skin to slowly stretch.

plumpous · October 2015

Did you have guidance pushing? The nurses gave me very specific instructions how to push. Left to my own intuition I would not have done it like that.

alinic916 · October 2015

It used to be the norm for doctors to perform episiotomies. It is much more common for them to let you tear now. It is supposed to heal better if you tear vs. Episiotomy. Very few women have no tearing at all.

midge519 · October 2015

I had an episiotomy with my epidural birth, a super minor tear that didn't require a stitch with my second (unmediated), and no tearing with this one (only had nubain). I think the big difference is how fast the baby comes. With my first I couldn't get him out so they did a small episiotomy, my second she was fast but the ring of fire was so intense I actually stopped pushing for a few seconds while allowed my body to stretch along with the Doctor using some sort of lubricant, with this one the doctor actually slightly pushed him back in to allow my body to stretch which worked perfectly.

plumpous · October 2015

I pushed for an hour and at the end she was almost out but her heart rate was dropping and the doctor reluctantly made the small cut to get her out safely.

Leabyrd · October 2015

I had an epidural and pushed twice (2 sets of 3). The doctor looked at the monitor and they could see a contraction coming on and told me when to push. I felt the need to just push her right out and my doctor slowed me down, she said short and little pushes, okay stop, okay small push and I had no tearing except for a little inside and I think I have 2 stitches. Baby girl was only 6 pounds 4 oz though. Definitely able to have an epidural without major tearing.

edavis926 · October 2015

I had a second degree tear but she was pretty tangled up in her cord. It was around her neck and her arm was pinned along the side of her head. She had to be vacuumed out because I could get her there but just no chance of getting her out. I definitely would've torn with or without the epidural.

My epidural helped for pain but I was very aware of every contraction and need to push and could feel my legs and stand the entire time.

dparker721 · October 2015

aprosch said:
It used to be the norm for doctors to perform episiotomies. It is much more common for them to let you tear now. It is supposed to heal better if you tear vs. Episiotomy. Very few women have no tearing at all.

This is what I was going to say. From what I've read/heard is that doctors are allowing tearing more often than episiotomy. I don't know if this has anything to do with there being a correlation between epidural and tearing though.

I also had an epidural and had a second degree tear. My recovery has been very well though. I didn't really know going in what is considered pushing for short/long amounts of time, but I pushed for 30 minutes total with taking breaks to give the doctor time to get in there. They told me they didn't expect her to come as fast as she did being a ftm, so I suspect that had something to do with my tearing.

cbolton19 · October 2015

I didn't tear until her shoulders came out and she had an arm up. My OB was really great. She had me push as I needed (no direction from her) until the baby started crowning. Then she had me slow down and breath the baby's head out. Letting the baby slowly crown allowed my body to stretch slowly. While I was pushing she also kept warm compresses on me to keep my skin soft and warm. If I hadn't bled more than they would have liked, I wouldn't have needed the stitch I got.

Sbrouwer0706 · October 2015

I had no pain meds and had a couple 2nd degree tears. My midwife guided me through pushing and placed her hands to try to minimize tearing. I've heard that tearing is extremely common. I don't necessarily think it has to do with the epidural.

komorebi · October 2015

afety: the best available research finds that epidurals:
increase the length of the pushing phase of labor
increase the likelihood of birth with vacuum extraction or forceps
reduce the likelihood of "spontaneous vaginal birth," that is, birth with neither vacuum extraction, nor forceps, nor cesarean section
increase the likelihood of maternal fever, which in turn increases the chance that the baby will have blood drawn to check for infection and will be given antibiotics through an IV (intravenous) line as a precaution
increase the likelihood of serious tearing of perineal tissue into or through the rectal sphincter â€” probably due to the increased use of vacuum extraction or forceps
can adversely affect newborn behavior compared with unmedicated infants
increase the likelihood of newborn jaundice (Leighton and Halpern 2002 and Lieberman and O'Donoghue 2002, systematic reviews
www.childbirthconnection.org

komorebi · October 2015

I've never used an epidural and never torn. It was my biggest reason for avoiding the epidural with my first born. I totally get the appeal of pain relief, but i can't reconcile the increased risk to avoid pain in the moment. But I've also had great labor support Ana access to movement and water to help ease my pain. I definitely would think twice if you made it through well once already.

momma2char · October 2015

I had an epidural and it took 2 hours of pushing before baby girl was out, could feel when to push by how much pressure there was down there during contractions. The epidural did nothing to help with pain from crowning and tearing- I could feel everything from that and pushed very slow through it so I personally don't think the epidural had any significanct impact on my tears

jburrell13 · October 2015

I'm a ftm, had an epidural due to all back labor and being unable to walk from my legs being shaky through contractions, it only took me 12 minutes to push our LO out, I could feel how hard I was pushing and I still had a second degree tear. I really think it's just how you're body handles birth, and your anatomy

BrandalynE · October 2015

I'm taking a natural childbirth class and you are more likely to tear with an epidural because you are numb and cannot feel how hard to push. Someone is telling you when to push and how hard. When you can feel how hard your body is telling you to push and feel it you're less likely to tear.

Krysta6 · October 2015

I got the epidural and I could feel my legs and contractions (of course not at their full intensity). I was even able to stand leaning and squating holding on to back of bed to help him move into my pelvis. I pushed with no instructions for less than 15 minutes and about 5 contractions (I think it's from having strong longs and working out pregnant!). I had a 3rd degree tear but I think it's because his head and body shot out so fast!! I was up and moving immediately after I got stitches up

amberrmariee20 · October 2015

I had an episiotomy with my first. He was 9.7 lbs, with a head of 38.5 cms. Dr said due to his size and position he wasn't coming out without an episiotomy !

anorthro · October 2015

I had an epidural. I pushed three hours and had the vacuum assist. I got a 4th degree tear. I'm sure my tear was due to the vacuum. Maybe I needed the vacuum because of the epidural, but I know a lot of people who got an epidural and pushed out the baby on their own just fine.

cbolton19 · October 2015

Krysta6 said:
I got the epidural and I could feel my legs and contractions (of course not at their full intensity). I was even able to stand leaning and squating holding on to back of bed to help him move into my pelvis. I pushed with no instructions for less than 15 minutes and about 5 contractions (I think it's from having strong longs and working out pregnant!). I had a 3rd degree tear but I think it's because his head and body shot out so fast!! I was up and moving immediately after I got stitches up

That is how my epidural was. I could get up and use my legs. And I could walk around after all was said and done.

ColoradoHiker · October 2015

cbolton19 said:

Krysta6 said:
I got the epidural and I could feel my legs and contractions (of course not at their full intensity). I was even able to stand leaning and squating holding on to back of bed to help him move into my pelvis. I pushed with no instructions for less than 15 minutes and about 5 contractions (I think it's from having strong longs and working out pregnant!). I had a 3rd degree tear but I think it's because his head and body shot out so fast!! I was up and moving immediately after I got stitches up
That is how my epidural was. I could get up and use my legs. And I could walk around after all was said and done.

They're actually called walking epidurals, and I've heard they're becoming more popular. It basically means the epidural isn't as strong, and you can walk around/ feel contractions and how hard you're pushing better, while still having pain relief. My hospital does these, but I still won't be allowed to walk around once it's administered, due to legal ramifications if you fall and are injured.

cbolton19 · October 2015

ColoradoHiker said:

cbolton19 said:

Krysta6 said:
I got the epidural and I could feel my legs and contractions (of course not at their full intensity). I was even able to stand leaning and squating holding on to back of bed to help him move into my pelvis. I pushed with no instructions for less than 15 minutes and about 5 contractions (I think it's from having strong longs and working out pregnant!). I had a 3rd degree tear but I think it's because his head and body shot out so fast!! I was up and moving immediately after I got stitches up
That is how my epidural was. I could get up and use my legs. And I could walk around after all was said and done.
They're actually called walking epidurals, and I've heard they're becoming more popular. It basically means the epidural isn't as strong, and you can walk around/ feel contractions and how hard you're pushing better, while still having pain relief. My hospital does these, but I still won't be allowed to walk around once it's administered, due to legal ramifications if you fall and are injured.

Ahhh. Ok. That is just what they gave me. So that was awesome. I felt every time I needed to push. In labor and delivery they let me walk, but in the mother/baby unit the nurse had to walk with me to the bathroom the first time. It was perfect though, enough to make me relax but still be in control of my body and pushing. I felt alllll the pushing. It was a hard decision to get the epidural, but I think I would have been in labor for much longer. I was so tense I wasn't progressing.

edavis926 · October 2015

cbolton19 said:
It was a hard decision to get the epidural, but I think I would have been in labor for much longer. I was so tense I wasn't progressing.

This was me. I was at 2cm from Thursday morning until I got the epidural at 5am on Saturday. I went to sleep for about an hour and a half and was 7 when I woke up. I was complete less than an hour after that. I was just too tense and definitely just needed to relax.

Edit: pushed post too soon.

Knottie1445378742 · October 2015

I had no tearing with this birth, which was unmedicated (7 lbs, 6oz), minimal tearing with my other unmedicated (6.1), and normal tearing (worse than the unmedicateds by FAR) with my two epidural births, so for me the additional effort to push when numb definitely led to more stress/tearing. I didn't even have hemorrhoids this time, which were really bad with the epidurals.

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