Having a vaginal tear or an episiotomy, which is a cut during childbirth can be quite an overwhelming thought for any woman.
There are preparations you can make during your pregnancy that will help reduce the likelihood and severity of cutting or tearing trauma when giving birth. I wish I had known these techniques as I was at the mercy of my doctor who made an incision and then that wasn’t enough and I tore. Your recovery postnatally can also be made more comfortable by taking certain measures.
So first of all, what is the perineum? The perineum is the area of skin and muscle between your vagina and your anus. This stretches when you’re giving birth and is where most tears occur. So imagine you know the size of your vagina widening to let that baby’s head through, and that’s perineum stretching quite a bit. And so it’s important for it to be nice and elastic so it can not tear.
So what can you do to prepare before the birth of your baby? First, do perineal massage! Research indicates that perineal massage from 34 weeks in the pregnancy can help reduce the likelihood of you needing an episiotomy.
Secondly, pelvic floor exercises can help to strengthen your muscles. Ask your midwife or your pelvic floor therapist for more information on how to do these. I’ve also made videos on my pelvic care course on how to do this.
Third, breathing practices. These can help you immensely to avoid spasming the pelvic floor. Just breathing and relaxing the pelvic floor area can go a long way. I also have videos on this.
Fourth, application of warm compresses. Evidence from research shows that warming up the perineum during labor acutally dilates the blood vessels, hydrates the skin and makes the perineum less likely to tear.
Fifth (and super important) you may want to avoid the coached pushing down during your birth and look at hypnobirthing and ways of breathing your baby down during the birthing process to help the area stretch more slowly and easily.
And I’m going to add one more to this. The traditional way of giving birth in a hospital is kind of in supine and and not really moving with gravity. So the position of birthing will really be more natural if gravity is helping you. So if you’re in a position where you’re squatting or in the water where you’re able to give a water birth, these things also are. The water birth is relaxing and can help ease the baby out.
And you know, again, I wish I was coached by a midwife or had someone like a birthing coach beside me there that allowed me to integrate the breathing in this way so that I was not pushing and tearing like I did. Some other things you can do – Did you know that physical therapy can help you? Specifically seeing a pelvic floor physical therapist.
A pelvic floor PT can help you create an individualized treatment program to help you improve and reduce the likelihood and severity of trauma from giving birth. And if you do have the trauma, they can help you in the aftermath with your healing, so make sure to look at resources available to you!