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lowering risk of tearing.. after a big one

post #1 of 12
Thread Starter 
I had a pretty massive tear with ds.
I really don't want to bust open again.

What is anyone doing to help prepare and prevent it from happening to them again? I've heard a lot about perineal massage in the last 6 weeks, but the stats I've seen say it's only effective for 1st time moms. I'm upping my kegels, and am hoping to try birthing positions like squatting, laying on side, on all fours, which I heard might help.
post #2 of 12
Quote:
Originally Posted by Oliver's Mama View Post
I had a pretty massive tear with ds.
I really don't want to bust open again.

What is anyone doing to help prepare and prevent it from happening to them again? I've heard a lot about perineal massage in the last 6 weeks, but the stats I've seen say it's only effective for 1st time moms. I'm upping my kegels, and am hoping to try birthing positions like squatting, laying on side, on all fours, which I heard might help.
"breathe" your baby out using physiological pushing rather than pushing at the order of someone else... trust your body.
post #3 of 12
Hot compresses are very helpful too. That's the real reason all that water gets boiled in the old movies. Practice squatting now, if that's something you're interested in doing. If your body is not physically prepared for it, you will be too tired to do it for very long. Also, like Riverbeauty said, breathe your baby out. I'm pretty sure that's a big reason I didn't tear. I just ignored all of the advice (mostly because I was all the way inside myself to deal with the pain) and let all my air out each time I pushed until the VERY end. It made me lightheaded to do it any other way.
post #4 of 12
I was just reading in my hypnobabies book last night that if at all possible you should attempt to push the head out BETWEEN contractions. So it doesnt 'pop' out forcefully with the power of a contraction behind it. Im going to 'try' this, not sure if i'll actually manage it as i didnt feel very in control of what my body was doing at that point last time
post #5 of 12
For me, it might be avoiding a posterior baby with a 15 inch head that might help. LOL I had a third degree tear last time and a second degree with my second child. I'm hoping to avoid a deep tear this time by birthing in the water, but I'll wait and see what happens at the birth. I wasn't able to push effectively in the water last time and birthed on the floor. I don't know if anything really truly helps, but things like perineal massage probably won't hurt.
post #6 of 12
This is something I'm hoping to avoid as well. I'm sure 'purple pushing' on my back in the hospital bed had everything to do with my 2nd degree tear.
post #7 of 12
From what i have read water helps a lot. you can ask ur midwife, nurse or partner to support your perineum while the baby is crowing, i have seen pics of mothers themselves also supporting it. In some of the natural birth stories I read, women have kept up mental images of opening up, opening huge and wide enough for a gentle birth- it is a good thing to do according to me since you have nothing to loose! Also I think it helps a lot if the people helping and supporting you dont force you to do anything you dont want to. also if you can kiss the baby's father during labor and pushing, that could help too!!! (Courtesy Ina May's guide to natural child birth). You can read about Ina May's sphincter law- where she says that keeping your mouth wide open and relaxed will also help!

My plan is to try everything that will not cause any harm and be hopeful about not tearing
post #8 of 12
My midwife massaged my perineum when I was pushing with DS which helped tremendously. I also didn't push his head out, but let it ease out on its own. I found it very hard to do this...you really have to focus all your energy on letting your perineum stretch over the baby's head all while dealing with the "ring of fire." I kind of felt myself (and this will sound totally hippy dippy, so be prepared) disconnect from the discomfort and imagine a glove sliding slowly over a hand. His heartrate was fine, so I was in no rush to push him out, and really let my body lead. Honestly, letting the head ease out was slightly easier than pushing it out, but my only pushing-it-out comparison is with DD3 who was 3lb at birth, so everything about pushing her out was extremely painful 'cause she came out so stinking fast.
post #9 of 12
DH and I have been doing the perineal massage. It doesn't feel very good and I can see how it would be helpful to relax to the sensation of something very big down there! And, well, maybe TMI, but after a bit of the massage I feel like I deserve something nice which feels a bit better and he is happy to oblige!
post #10 of 12
I birthed on all fours last time and didn't tear a bit, even though dd2's arm came out with her head.

I think the position helped a lot. I also think my OB's guidance was helpful, as he used short, one-word directions to help me ease her out rather than letting me push forcefully (he didn't tell me when to push, just gave me directions on how to push when he saw me pushing). It was hard to hold back, but I trusted him and followed his words and she came out little by little until the head and arm were through, which I do believe made a difference, both in my tearing and in her not having a dislocated shoulder.
post #11 of 12
The biggest changes for me that meant tearing versus not tearing were not have an epidural and pushing when my body couldn't hold back from pushing any longer. Being able to get in to the position that is most comfortable for your own body and working with it is really important.
post #12 of 12
My mw did hot compresses, pressure, and mineral oil on my perineum. I did kegels and perineal massage leading up to birth. Since this is my second, I am just going to focus on the kegels and ask this midwife if she does the compresses and oil. Worked really well last time, but position, size, and stretchiness definitely has a lot to do with it.
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