8 Tips to Prevent Vaginal Tearing During Childbirth

The fear of vaginal tearing is an overwhelming concern for many pregnant people. Tearing happens during childbirth as your baby stretches your tissues; they can occur internally as well as externally, on the labia or perineum. Episiotomies used to be much more common, but research now shows that allowing your body to tear naturally leads to lesser severity of the injury and better healing outcomes. Here are a few tips that you can use throughout pregnancy, labor, and childbirth to prevent vaginal tearing:

1. Perineal massage: Ask your provider before starting the perineal massage. Find a comfortable position (try the bath or shower). Using clean hands, insert both thumbs into your vagina. Gently press them down towards your bottom and you will feel the perineum. Place light pressure and move back and forth in a “U” motion gently stretching those tissues for about 3-5 minutes daily. This will feel like stretching a muscle and may feel uncomfortable. Stop if it is painful or makes you bleed. Using Vitamin E oil can act as a lubricant, but also promotes elasticity and hydration of the skin.

More resources for perineal massage:

https://www.lamaze.org/Connecting-the-Dots/what-is-the-evidence-for-perineal-massage-during-pregnancy-to-prevent-tearing

https://www.nct.org.uk/pregnancy/worries-and-discomforts/common-discomforts/how-do-perineal-massage-step-step-guide

https://www.fairhavenhealth.com/babyit-perineal-massage-postpartum-tear-gel?utm_source=APA&utm_medium=text&utm_campaign=babyit

2. Evening primrose oil: Many people take evening primrose oil supplements orally as well as vaginally in their third trimester. It contains linoleic acid, an Omega-6, that can help ripen the cervix and promote elasticity and relaxation of the surrounding tissues (when used vaginally).

3. Sitting on a birth ball: Using a birth ball during pregnancy labor will keep your pelvis open and supported. Doing figure eights, hip circles, and pelvic tilts on a birth ball during your pregnancy can also help strengthen your pelvic floor and help prevent tearing.

4. Using gravity to your advantage: An upright or all-fours position during labor and birth will allow your baby to descend through the birth canal more easily. While pushing, an upright position utilizes gravity to birth your baby without placing added strain on your body.

5. Waiting until you feel an urge to push: Waiting until you feel an urge to push during labor will minimize pushing time and, in turn, decrease the stress on your baby, your body, and your tissues.

6. Warm compress: Your provider may place a warm compress on your perineum while you are pushing to relax the tissues.

7. Mineral oil: Your provider may also use mineral oil on your perineum while your baby is being born to allow the head to slip out more easily.

8. Most importantly, breathe and relax your body: A calm environment will keep you relaxed, in turn, keeping your pelvic muscles relaxed. Breathe deeply and visualize sending oxygen down to your pelvic floor. A steady and controlled breath (NOT one giant push) as your baby is crowning is often the difference between someone who tears and someone who does not.