if you tore significantly what position were you in?

[octobermoon]

i'm trying to figure out why i tore so badly, trying to make some sense of my son's birth. i know i may never know for sure but still there is a nagging feeling behind my birth experience. a longing for questions to be answered and to have some closure already. Ds is 10 months and i am still processing our ordeal.
i wanted to know if you tore did you squat? what position did you use? i used a birthing stool and i also leaned on the bed with my head down for the last part of the birth. i'm not sure exactly how long i was in this position. i do know i could feel my baby's head with my fingers only an inch or so up the birth canal. a couple of birth professionals feel that my squatting could be the reason i tore so badly (almost 4th degree, slight tear through to rectum). i did have to climb up on the bed for him to be born and sort of squatted but leaned back on my hand. he came out with his hand up by his head as well. i also pushed a lot because it felt good to do so. it was almost like if i pushed really hard i didn't feel the contraction as much....or maybe i just wanted it over with, i don't know. all in all the labor -up until the birth- wasn't too bad for me, it was doable.
there was other trauma to my story but for starters i'm scared to death of having another baby and tearing. although it seems the outcome for subsequent births for a lot of women who have torn are pretty good. however there aren't any guarantees.

anyway what happened with your tear? has anyone figured it out?

[mommy2maya]

I would be more suspecting of the nuchal hand causing the extreme tearing than the position. I've heard over and over that squatting is one of the best positions, with giving the most head room.

[Ceinwen]

I was in a supported squat and had a fourth degree tear.

The repair and recovery was worse than the labour and birth.

I was so scared to tear again, that I opted for a c-section the second time around.

This is not necessarily the right decision for everyone (by far) but I had nightmares, anxiety attacks, cold sweats, etc. for months leading up to my approximate due date - and in the end, chose for a managed delivery.

[imagine21]

My son seemed to come out shoulder first and I tore pretty badly...I was squatting. The recovery wasn't too bad at all. My doctor did an incredible job stitching me up, took extra time (well over an hour) and did a double layer of stitches. DH is particularly impressed with the doc's work.

[oddduck]

3rd degree tear, plus vaginal tear from cervix down and a labial tear. I was leaning over the back of the bed on my knees. DD2 also had a nuchal hand.

[Hedgehog Mtn]

I've had 5 homebirths. 4 were in a semi-sit (my choice) on the bed or floor and I tore. #5 was kneeling while leaning my arms on the seat of a chair and I tore. My babies were between the range of 6-7 lbs for 4 of them and the middle was 8lb 9oz.

[octobermoon]

My doula says even though there isn't much textbook evidence she has seen a lot more tears from squatting. I have also read that countries that do squat for birth like China and Brazil squat differently than women in the U.S. Which is where I am. A midwife did warn me going in but the position I took was most comfortable for me all the way around. I don't think I would use it again. My son was only 7.4 pounds. He also came very fast and I was on a higher than average amount of pit for an induction because of suspected HELLPS. Maybe the reason for my tear was more than just squatting.

[MrsJewelsRae]

I had a 3rd degree tear from my first birth, as well as 2 large internal tears. I attribute mine to a few things- my position, position of the baby, force of pushing, nuchal hand, and the nurse who basically started the tearing for me by doing a violent stretching and pulling version of perineal massage. I was forced into a litheum position without the stirrups, coached and yelled at to push till I was blue in the face and my son had a hand by his face at birth. DS had a large head and shoulders but was only 7 lbs. Oh, and I was very very swollen due to pre e and I think swelling can cause the tissues to tear easier, and definitely takes longer to heal.

I pushed in a more upright position for #2, a homebirth, no coached pushing, only pushed 3 times and birthed an 8.5 lb baby with no tearing at all. No perineal massage, just support as the baby was coming out.

For my third I had a hospital birth due to high bp, but with my midwives only in attendance. I pushed according to my urges again, but once his head was born his shoulders were a little sticky so my midwife immediately pushed me into a flat on my back position with my knees way up by my ears (I held them myself), I knew he was in distress and I pushed like heck even thinking at the time I was going to tear like crazy from the position. But I did not! 8.10 lb baby born in under 5 mins pushing and not a single tear, I was not even sore afterwards.

I hope you have a similar success story with your next child.

[octobermoon]

i barked at my MW it felt like the whole time, she kept trying to touch me, break my water etc.... she didn't do anything i didn't want. i could tell though at the end she was annoyed and said something about the tearing and the fact i wouldn't let her support my perineum. IDK if i should have let her support it or not i probably had already torn by that point. i just kind of did what i felt was right at the time. apparently i may have messed up. don't know.

[JessieBird]

For the last two pushes that got my DS out, I was in a reclining seated position at the end of the bed. I think my feet were up on the edge of the bed, or maybe they were on the floor, I can't remember. Moments before and for the previous 30 minutes or so, I had been standing up with arms above my head holding on to a vertical pole, alternating one leg up on the edge of the tub then the other with each push to get him to descend.

When he was crowning, my MWs could tell that I was going to tear and they told me to slow down and let them help me to take a few pushes to ease him out. No way! I was too excited and just shot him out. I didn't care one bit about the tear and to this day I don't know to what degree it was or how many stitches I had (DH knows and he just says "a LOT"). All I know is that my MW was down there stitching for a LOOOONG time and she was very proud of her work, everyone gathered around to admire. I actually found it all really funny, though looking back now I'm not sure why that would be funny. I'm usually soooo modest. Recovery was fine.

I'm pretty sure that there are things I could have done to prevent the tear - pernium massage and stretching in advance of the birth (never bothered) and slowing down that final leg of DS's journey but for some reason I just don't care. It was an exhilirating exprience, doesn't matter if it wasn't "perfect" because I did exactly as I felt was right in that moment. I think it helps immensely that my midwives, even though I disregarded their advice and wouldn't let them help, never made me feel badly about tearing. No one ever implied that I could have done better. I'm really sorry that yours made you feel this way especially if you were just doing what felt right to you. I think birthing is a balance between listening to our own instincts and letting the knowledge of others guide us. When it comes down to it though, our bodies have very powerful voices and there is no shame in listening to them.

[mrscompgeek]

I was on the birth stool when I tore with my DD. Mine was bad, Ended up in the ER because it was so bad, took them 45 minutes to stitch me and had to give me spinal block to stitch me. (It was a homebirth) There was a few other things that could have caused tearing but I do know I will NOT be on a birth stool next labor!

[hollytheteacher]

on my back with an epidural...probably pretty common

[Super~Single~Mama]

I was laying on my back (he had to come out quickly at the end - I'd been pushing for ages, and I was getting oxygen so that he and I would get enough since I was hyperventilating), and I had a REALLY bad 2nd degree tear - it took 3 midwives to determine it was 2nd degree and not worse. It was an un-medicated birth at a freestanding birth center.

[Fujiko]

I had a third degree tear. I was on my hands and knees in a birth tub. DS had his fists up under his chin, and I'm confident that's why I tore. In fact, I didn't tear until AFTER he crowned, as his shoulders/arms/fists were born, so I know that's why I tore.

I would do it the same way next time. Who can plan for or prevent nuchal hands?

I've read a few threads on these boards that indicate that women who have a bad tear with one delivery aren't necessarily more prone to tearing badly later. So while the stitching up after delivery was WORSE for me than the labor and delivery itself, I personally will still go the same route and hope for the best if/when we have a third child.

[texmati]

Octobermoon, I just wanted to give you a hug! I hope that you are healing well.

[limette]

I was half in the standard half sitting/half laying position when I got my third degree tear. Oddly it was the only position I felt comfortable in. Baby was posterior and took forever to come down. I pushed for 2 hellish hours.

[azmomtoone]

Originally Posted by hollytheteacher

on my back with an epidural...probably pretty common

Same here -- 4th degree tear. BUT -- shoulder distacia also, he was actually 'born' by the nurse pushing my belly to push him out.

[flavorfull1]

I was squatting while leaning back a little on my husband's knees. DS had a hand up by his head as well and I had been pushing for 5 hours. I think all of that pushing increased swelling before he came out which might have made the tearing worse. I still have tenderness/pain where I tore. I tore on my labia and perineum. I do have anxiety about the next one and really not wanting to tear. I think recovery will be better no matter what if I don't have to push for that long again. Squatting was the only way that baby was coming out, I tried all of the other possible positions and that one worked. He had his cord wrapped around his neck and over his shoulder and around his body. Not related to the tearing but related to the pushing. I am sorry that you have been made to feel like it was your fault for not letting the mws touch you. If you didn't want it, it was right at that moment, don't let anyone guilt you into not trusting yourself!

[octobermoon]

Originally Posted by texmati

octobermoon, i just wanted to give you a hug! I hope that you are healing well.

thank you

[dachshundqueen]

First kid, lithotomy (bad sp) small tear, tiny 5#12oz baby big head. Second kid, support standing squat bad tear 8#+ baby.
Well, with my second I pushed through crowning and my kids have HUGE heads (90th+ percentile) so no, that didn't end well. Apparently I was yelled at not to push or something, but I was in la la land and heard no one except the bowling ball pressing down on my bits. LOL

Liz