When a baby’s head crowns during childbirth, the tissue around the vaginal opening can tear. Tears range from mere skin snicks that heal on their own after childbirth (these are called first-degree tears), to tears involving vaginal tissue and the perineal muscles, which will need a few stitches in the delivery room (second-degree tears).
Although this sounds scary, you’re unlikely to feel the tear during labour, since the skin is stretched taut, which makes it numb. Afterwards, however, pain will vary depending on the severity of the tear. As most tears are either first or second degree, in most cases you might feel stinging rather than a throbbing pain.
There’s no guarantee that you won’t experience some degree of tearing during childbirth, but there are ways to minimise the risk and reduce the severity of the tearing.
1. Prepare your body
This sounds simple, but it’s important to ensure that your body is prepared for the work of labour. Follow a healthy eating plan and, if your doctor gives you the go-ahead, include daily exercise in your routine during pregnancy. Exercise improves circulation, which in turn improves skin elasticity, while good nutrition and hydration support skin and muscle health.
2. Start squatting
Squats (where you stand with legs shoulder width apart and squat down to 90 degrees) will help to prepare your pelvic floor muscles for birth and strengthen your leg muscles during pregnancy. By performing a variety of squats you’ll have more endurance in your birthing positions. This will also allow gravity to assist with making the pelvic opening wider, giving your baby a bit more room to push through.
3. Consider a water birth
Studies have shown that water births are considered much less painful, because the warm water acts as a natural pain reliever. It also helps to relax and calm you down during contractions. The jury’s still out, but some studies do suggest that lukewarm water may lower the chances of severe vaginal tearing and may also improve blood flow to the uterus, according to WebMD.
4. Choose the right birth position
The position you are in when pushing plays a big role in whether or not you will be at risk of tearing. The best position for birthing your baby is the one you feel most comfortable in. But some of the least stressful positions for the perineum include:
• On your hands and knees
• Leaning forward in a supported standing, kneeling or sitting position
• Lying on your side.
5. Perineal massage
Preparing the perineum has been shown to reduce the risk of tearing in moms having their first vaginal birth. According to the National Childbirth Trust in the UK, it’s quite simple to perform a perineal massage. The perineum is the area between the vagina and the anus. Here’s how to massage the area:
- Lie on pillows on the bed, with your legs bent at the knees so you or your partner can reach your perineum.
Massage oil (preferably vegetable-based) into the skin of the perineum using fingers and thumbs.
- Then place your fingers around 5cm inside your vagina and press downwards towards the anus; move to each side in a U-shaped stretching movement. This may give a tingling/burning sensation.
- Hold the stretch for 30-60 seconds then release.