5 Ways to AVOID Vaginal Tearing | Perineal Massage, Birth Positions, Breathing Techniques For Labor

hello and welcome to practicing postpartum tv today we're talking about all the strategies to prevent or reduce the risk of tearing during labor there are two main principles that we're going to focus on one is slowing down the head through the birth through the vagina allowing the tissues to respond and stretch and the second strategy is increasing the capacity for the tissues to stretch of course this is general information only i'm not a physician or a midwife every birth is unique so talk to your provider about what's best for you and your birth i do also want to mention the different types of tears that we can have there are first second third and fourth degree tears and there is a big difference so first degree tear is really you can think of just like a little scrape it's not going to need any stitches second degree is going to involve a little bit of the muscle and it may need stitches but it may also not require stitches some of the newer research is saying that it may not third and fourth degree tear are the more severe tears involving the muscles and even the tissues around the anus the first strategy is to use techniques to slow down the birth of the baby's head as it's coming through the vagina you may know this phase as the ring of fire which has been known to feel like burning sensation as the baby's head is stretching those tissues so naturally you may feel the instinct to hold back and not to support that pushing so much which can protect these tissue and allow them time to stretch and let baby out and your provider may also be directing you at that time to slow things down maybe to breathe baby out a breath that may feel helpful you may instinctively do is which is a more shallow breath and your provider can also give you some guidance but also listen to your instincts and what your instincts are telling you here research also shows that birthing your baby in more than one contraction can help reduce the risk of tears and this was something that surprised me i think i'd seen in movies or videos the baby just kind of all coming out very quickly at the very end and it was a surprise to me that my baby would the head would be out and then i would be waiting for two minutes for the next contraction with my baby half out of me but the baby's head might come out and then the shoulder and then the rest of the body and to slow that down can reduce the risk of tearing you may also instinctively reach down and feel your baby's head or protect your perineum yourself which can help or you may want to close your knees and so historically providers have gotten women to open up their knees but this actually stretches the tissues around there but if we close our knees and even i'm going to talk about this next bring our heels apart like if your feet are up on a peanut ball this can actually allow more give and stretch in those tissues having your knees together can also open the widening of your pelvis and help baby come out as long as baby is already engaged it can help it come out the bottom so you absolutely don't have to have your knees wide apart to birth your baby your baby will just come out the back so really this is just another reminder to talk to your provider and be able to listen and follow your body's instincts when you're birthing your baby this brings me to my next point which is to talk about the positions that reduce the risk of tearing there's lots of research shows that any of the upright positions decrease risk of tearing whereas lying on your back or semi-supine sort of um seated but still on the bed or if you have your feet up in stirrups are going to increase risk of tearing at the most and you can see as the tissues are going to be stretched in those positions and there's not going to be any movement of the pelvis whereas if you're in positions where you have movement there it's going to decrease risk of tearing so i love also changing birth on earth which is gail tully's he was a midwife and it goes even further to say that the best positions here are going to be hand and knees and then side lying down which in both of those positions allows for the knees to be closer together and allow more stretch and lacks on the tissues around the opening if you're on your hands and knees you have the possibility to arch your back if that's what instinctively feels good as the baby is crowning and coming out and same thing on your side you could even use a peanut ball and keep your knees together and then use the peanut ball to bring your ankles or your feet apart allowing the widest opening and also giving lots of lacks to those tissues the hands and knees positions and side lying positions provide the same benefit of widening of the pelvis and movement of the pelvis that all of the upright positions have but it doesn't have the direct pressure on the tissues like squatting would have so for earlier on in labor squatting and the upright positions may work well but for the phase of the second phase of labor when the baby is crowning it may be beneficial to move to the hands and knees or sideline position to slow things down a little bit to protect those tissues epiphyseotomies also increase the risk of severe tears so you can think of if you are cutting a cloth and then pulling on it if there's already a cut there then you're much more likely to get a tear in that spot so historically epiphyseatomies have been really overused i think a lot of providers now are hopping on board and trying to use them only when absolutely necessary it's a good idea to have this discussion with your provider and choose a provider that wants to limit episiotomies as much as possible the research on using warm compresses and perineal support during birth is mixed with a hands-off approach so some studies show that there is a decreased risk of tearing using warm compresses and hands-on support but then other studies show that a hands-off approach for example in a water birth the provider is more likely to have their hands off and not touching at all is decreased risk for epiphyseatomy and epiphyseatomy is at decreased risk for severe tears so the research is a little bit mixed so i think following your instincts talking to your provider about what is best for you so in my second and third birth i had uh vulvar varicose veins that the provider was worried about and so they wanted to be holding the vein and so they had their hands on anyways and so a hands-on approach was better for me but again talk to your provider and talk about the benefits and the cons and what is going to work for you in your birth other research shows that birthing at home or having a home birth is your highest chance at reducing any tears at all however the tears at home versus hospital for severe third and fourth degree are exactly the same last but not least we're going to talk about perineal massage perineal massage is massaging the perennial tissues usually starting at about 34 or 35 weeks pregnant some moms do 10 minutes a day or maybe only one to three times a week but you can insert two clean lubricated fingers and massage down and massage on the side stretching and massaging it should not be painful at all research shows that there was a benefit to first-time moms to reduce the risk for tearing involving stitches however this was not true for second time moms or if they've had more than um the one baby there was one study showed that even for second time moms at the three-month follow-up they had less ongoing pain around the perennium it's also very low risk and so it was something that i did just to see if i could prepare my tissues and i felt good about doing as much as i could to reduce tearing i hope you found those strategies and tips helpful and gave you something to think about and practice while you're preparing for your upcoming labor if you have any questions or comments please feel free to leave them in the comments below i will keep making pregnancy workouts and yoga every week birth education as well as core healing videos after you've had your baby if you like videos like these please subscribe hit the notification bell and to support me share this with another mom friend or mom community that you think would enjoy it i also have lots of free resources for pregnant moms in the description box below a meal plan that i put together as a registered dietitian a guide on how to reduce and cope with pain during labor as well as a pelvic floor guide on how to prepare your pelvic floor for birth and the fastest recovery after if you enjoyed this video i'm also going to link to another video that you might find helpful as well as the whole prenatal yoga and workout playlist you can save this and come back to it whenever you like

Channel: Pregnancy and Postpartum TV

Views: 980,291

Keywords: breathing techniques for labor, birth positions, perineal massage, vaginal tearing, perineal massage during pregnancy, perineal massage to prevent tearing, how to do perineal massage, how to prevent vaginal tearing, birth, labor positions, tearing during birth, tearing during childbirth, tearing during labor, best birth position to prevent tearing, how to prevent tearing, how to prevent tearing during birth, how to prevent tearing during labor, prevent tearing during birth

Id: aqLO5esBo0M

Length: 8min 52sec (532 seconds)

Published: Fri Feb 19 2021