Did you tear again after a 3rd/4th degree initial tear?
I have not torn with any of my births. But I do know it is entirely possible to not tear in a subsequent birth. I do not know the circumstances of your first birth, but if you received an episiotomy you can place the blame firmly on that procedure. Other things that contribute to tearing are:
-epidurals or other pain relief which prevent you from feeling what is going on and adjusting your position and pushing accordingly
-doing 'purple pushing' (often at hospital they will chant "push 1,2,3...10") which will again not give you control of the pressure of the baby moving through you
-using instruments like forceps or a vacuum extractor
-having the baby manipulated out of you- many practitioners reach their hands or fingers into the vagina and turn the baby or pull it out
-having a yeast infection will make tissue much more fragile
-laying on your back
-the position of the baby
-induction of labor and the use of pitocin
So, to help prevent tearing, make sure your tissues are healthy (no yeast). Practice relaxing your vulva with squats where you just breathe and let everything release, keeping your jaw loose. Enter labor naturally, letting the process of your body being fully ripe and soft to take place, avoiding pitocin. Avoid drugs so you can feel what is going on and move about freely. Ask your doctor or midwife to practice a 'hands off' catch, letting the baby slide out on its own into her (or your) hands. Push and birth on your side if comfortable, which studies show is the position that causes the least amount of tearing. Discuss this with your doctor or midwife so you are on the same page with these things, and write it into your birth plan if you have one.
My first birth I had a 3rd, almost 4th degree tear. But he was vacuum extracted so who knows what would have happened had he come out naturally. My second baby I tore again, but only 2nd degree that time and recovery was much easier. I think I tore partly because her hand was next to her head when she was born (nuchal hand) and she was born quickly (4 minutes of pushing). My 3rd baby I tore again (not sure of the degree of the tear). Recovery was must easier too. I did bleed badly though from the tear because I tore an artery when I tore so I bled a lot. But once the bleeding stopped and I was stitched up, I healed quickly. With that birth, I think I tore because she was born really quickly too (14 seconds). I would LOVE to be able to slowly and gently ease a baby out to decrease the chances of tearing, but I never realize I'm ready to push until I'm pushing (fetal ejection reflex) and then the baby just flies out. If I have any more babies, I'd love to try to slowly ease the baby out, but so far I haven't been very good at that, lol!
sharing a client's experience: about 6 yrs previously...mother sustained a 4th degree with her 1st (CNM delivered - I believe location was a birth center -mother could not remember if her expulsive efforts were directed). Expecting her 2nd she engaged my care and planned a home birth. EPO, daily 20 minute sitz baths last weeks of pregnancy and 2 other little helps. She labored well- but when baby began to descend she became fearful. It was unfortunate- but baby had her arm up and during descent mother began to feel 'the burn' . Mother and I worked together to ease the emergence of her baby's head (water birth) and her 1st born caught baby sibling . skid marks only. Not sure why she tore so badly with her 1st.
Sandra Hess, CPM
1st birth was pretty bad, but that was hospital on my back.
2nd birth I just had a tiny tiny tear, my MW wanted to put in 1 stitch and I told her to just leave it alone. It never even bothered me. This baby was pushed out in just a few short pushes, quite fast so I'm surprised I didn't tear. Must have been a favorable position for me (birth stool).
I had a 3rd degree tear with my son that took a long time to heal. BUT the good news is that I did not tear for my 2nd or my 3rd..thank God.
The only difference with them is my pushing position. For my first I squatted and for the last two I did hand and knees, not sure if the position was the reason.