Perineal protection at the time of birth Your healthcare professional will work with you so that you can birth in your chosen position. A kneeling, or all-fours position, or lying on your side, may be beneficial and reduce the severity of tearing.
Birthing in the side-lying position has been shown to reduce perineal tearing by allowing the presenting part to descend more slowly (Shorten, Donsante, & Shorten, 2002).
Prepare to push.
During the second stage of labor, the pushing stage, aim for more controlled and less expulsive pushing. Pushing the baby out gently and slowly can allow your tissue time to stretch and give way for the baby.
A warm compress as you are pushing
While you are pushing, ask your nurse or doula if they can assist you in applying heat to your perineum. This can simply be a washcloth that is soaked in warm water. It's super easy, and this is one of the most effective ways you can decrease the possibility of tearing.
Side Lying
Since it is gravity-neutral, it may work to slow down your labor or birth. It can also be used for taking pressure off the perineum and lowering the risk of perineal trauma. This position may be used in conjunction with epidural anesthesia or other medications.
squatting, using a birthing stool, ball or squatting bar; this can help the flow of oxygen to your baby, reduce back pain and move the baby correctly into position. sitting and rocking on a chair or edge of the bed. sitting backwards on a chair, with arms resting on the chair-back. leaning forward over the bed.
If you're 4cm dilated and feeling a strong continuous urge to push (very unlikely) - then that's not ideal…often any pushing urge this early passes if you change position. But if you're close to 10 centimeters dilated the research suggests it's not an issue.
Up to 9 in every 10 first time mothers who have a vaginal birth will experience some sort of tear, graze or episiotomy.
And to that end, there are some methods providers use during your delivery that aim to reduce your risk of tears. Research shows that perineal massage during delivery by your provider can help to stretch your perineal tissue to lower your risk of significant tears.
Often your body will push or bear down without you even realising it. It is an instinctive reflex and is almost impossible to stop, so it is best to go with it. Due to the amount of pressure caused by your baby's head on your perineum, it is unlikely that you will feel any tearing.
But many variables can affect how much lubrication your body produces. And if there isn't enough natural moisture created, tearing can occur. “Vaginal dryness is often part of the problem, because dryness creates friction, and that's the main reason the tears and abrasions occur,” says Dr. Evins.
Is it better to tear or have an episiotomy? The latest research suggests it's better to let the perineum tear naturally. Healthcare providers once thought making a surgical incision would help the vagina stretch and prevent severe tears.
Squatting is a great way to give birth, as it enlarges the pelvic opening and gives gravity an opportunity to help the process. In order to squat during childbirth, keep your knees wide and feet flat and parallel to each other. Use your partner, care team, doula or a birthing bar to support you as you push.
Many Say Contractions Are Worse Than Pushing. Engaging surveys aside, the most common labor experience for birthing parents is that contractions are more painful than pushing.
Second Stage or Active Labor
The second stage, also called active labor, is the pushing stage of labor. The second stage is the most painful stage of labor. The baby passes through the cervix, through the pelvis and birth canal, and out through the vaginal opening.
You can flip onto all fours or even move into a supported squat position! If you need tons of physical assistance to move into a position, then it may not be safe for you, and we may want to focus more on positions that are supported by the bed, such as supine or side-lying.
First-time parents are more likely to experience tearing than those who have already delivered a baby. Other factors also contribute to your likelihood of lacerations, such as being overweight or having a fast birth, since the tissue has less time to adapt and stretch as the baby comes down.
Choose your own pushing position.
If you have had an epidural, try sitting up in a throne position or laying on your side, instead of on your back.
Short answer: yes, unmedicated birth absolutely reduces risk of tearing and decreases length of pushing if the birthing person is working with a supportive provider and has the birth education/support to advocate for best practices.
Around 27% of women experience no tearing at all, while 23% have a very minor vaginal tear or graze that often does not require stitches and heals on its own. Around 26% of women have a perineal tear that may need to be stitched.
Perineal tearing is much more common during a first birth than subsequent deliveries, but it can happen during any vaginal birth. Some tears are almost like scratches that heal on their own.
Nurses aren't necessarily being cruel when they instruct mothers to stop pushing, by the way. They may be hoping to prevent other complications, such as problems with the umbilical cord or shoulder dystocia. A doctor or midwife is better trained to correct such situations, and can also help prevent perineal tearing.
Purple pushing, coached pushing, holding your breath, all mean basically the same thing. Mothers being instructed on pushing causes them to hold their breath and push down into their bottom. Another more normal and less exhausting option would be “breathing or bearing down” working with the contractions.
Until recently, women have been asked to start pushing as soon as the cervix has dilated to 10 centimeters, but as long as you do not have a fever and your baby's heart rate is normal, there are many benefits to waiting to push until you feel the need to push.