Physical issues with homebirth *TMI*

[NJ*Doula]

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[boscopup]

Originally Posted by GathererGirl

Also, and this is way TMI and a bit selfish, what if my husband (and me, believe me I've thought about it) doesn't enjoy sex with me after I'm all stretched out? We have a great sex life now, and I'll be sad if that changes.

For your first questions, I'd probably talk to a midwife about it. But the above question I wanted to give my input on... I found that after I had my baby (and fully recovered and got some libido back... pretty much happened when AF returned), sex was *more* comfortable because I was stretched out a bit. Before, it would sometimes hurt, especially if it had "been a while". But post-baby (again, months later - not right away!), it felt better than ever. Don't ask me why! It just did!

As for pain during labor. Yes you can do it. Just educate yourself on natural childbirth, take a good class (like Bradley or a hypnobirth type class), have a good midwife and maybe a doula present, etc. But believe in yourself. Childbirth pain is alot easier to take because of that prize at the end. With other pain you've had in life, there wasn't really any prize for going through it, ya know?

[Mama Poot]

I was uncomfortably tight "down there" and it was a drag until I had my first child. I was given an episiotomy because I "started to tear", but it was small, and once everything was healed and DH and I could have sex again, I was delighted that I was not "stretched out", but rather I was *almost* as tight as I was before I had the baby!! The vagina is an incredibly resilient thing, so I would not worry too much. As for not having a perineum, I don't know anything about that condition. That will be something you should talk to your doctor or midwife about. I would think as long as you had a practitioner there with you at home who was very confident and had excellent stitching skills, and they didn't think you would tear all the way through to your rectum, you could give birth at home, sustain a fairly bad tear, but get through it just fine.
Also keep in mind that if you give birth at home, certain "routines" like coached pushing ( also known as "purple pushing" ), routine episiotomy, being forced to lay on your back or halfway on your back to deliver, not being allowed freedom of movement, being given drugs that slow labor or epidurals that make it impossible for you to feel contractions when you NEED to feel them, all of those things that pretty much can guarantee 100% that you will tear or at least not come away from the birth with an intact perineal area, when you are at home those complications will not exist.

Some things you can do in the meantime if you're worried are:

Stop using harsh soaps and shaving your pubic area. It is important that the skin be very supple in order to prevent damage, and shaving really wrecks the skin.
Massage the whole area with oil, like olive oil on a regular basis.
Take a fairly hot bath regularly. Sitting in warm water allows the pores to open and take in more moisture.

HTH!

[blissful_maia]

What do you mean by you have no perineum? Like you have a very small space between your vaginal opening and your rectum or you have actually been told you have no perineum? I can see birth being pretty difficult with no perineum since a lot of the stretching that needs to happen to accomodate the birth of the head happens there, but if it is just a variation of normal I am sure it has been done and you could do it!

[bradleybirth2mom]

I woul read Ina May's Guide to Childbirth and know that your pelvis can expand up to 30% while squatting----traditionally, doctors measure your pelvic opening while you lie down on your back without taking into account that you can expand it in other positions, like hands and knees and squatting. Your pelvis is like a clothespin---hard on the outside and flexible in the middle----cephalopelvic disproportion is a rare thing, happening in 2% of women, and you probably don't need to worry about it. I would post this on midwives, doula and childbirth educators' forum instead since I can't give you better advice than you probably have no issue preventing you from a natural birth. Also, I was a size 0 before pregnancy and gave birth to a 8 lb, 10 oz baby with a tear I could never see. Tearing worse than a one-degree is not very likely with midwives since they support your perineum with their hands and massage it to support its flexibility during labor. Tearing to a third-degree extent is far more likely in a hospital since they do episiotomies that increase that risk. Good luck!

[bradleybirth2mom]

also, you can tighten up postpartum by doing Kegel exercises---take a Bradley birth class and/or get the book Natural Childbirth the Bradley Way by Susan McCutcheon. It tells you how to relax for birth and do the Kegel exercises.

[Quagmire]

Originally Posted by boscopup

I found that after I had my baby (and fully recovered and got some libido back... pretty much happened when AF returned), sex was *more* comfortable because I was stretched out a bit. Before, it would sometimes hurt, especially if it had "been a while". But post-baby (again, months later - not right away!), it felt better than ever. Don't ask me why! It just did!

: Some sensitive spots I never had seemed to develop after the birth of my first. (Sex is pretty amazing now ) Just need to give yourself time to heal and take it easy! For me it was before AF returned, but it did take several months and lots o lube.

On the no perineum issue, not sure about that. Definitely chat with your midwife. But I'll bet your body knows just what to do - the pelvis is pretty amazing!

[laohaire]

I was tight before birthing. I tore, but I actually didn't feel it. Not to say that the whole process wasn't painful, but I didn't actually feel the rip. It was fine. I got a ton of stitches.

I would venture to say that after a few months - like 6 months - sex started feeling more pleasurable to me since I'm not so tight anymore. As for my DH, he notices it's not as tight, but he's fine with it, and in fact likes that I like it better now. Any DH who prefers you to be tight and in discomfort to being not so tight and in pleasure - well, I won't even finish that thought.

[NJ*Doula]

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[cottonwood]

Have you considered it being a hormonal/psychological issue?

When you're fully sexually aroused (and birth is allowed to happen spontaneously and uninhibited for that matter) the vaginal walls become lubricated, swollen, and stretchy. If you are using lube, I'm guessing that you're not then fully sexually aroused, and if you're not fully sexually aroused, the tissues won't be swollen and stretchy either, and no amount of lube is going to make up for that. My husband can't even enter me until I'm fully aroused, and gynecological exams are quite painful for me. But I can fit a baby's head through my vagina without tearing, and I can enjoy intercourse. Hormones hugely affect what your body can do.

[bobandjess99]

Well, I'm barely 5 foot tall, small build.

And has been said, you will stretch and TRUE CPD is VERY rare.....

Personally, i had expected to "feel" the baby, I don't know..like, hitting the bones on the way out....you know? sort of grinding it's way out...But I didn't.

I had a VERY small vagina pre-birth..like, couldn't get a speculum in there with a pile of lube and a shoehorn, LOL! ...but apparently, a sufficient pelvis, because the baby burst right out, no problems, not even a hint of dystocia or anything...
Now, I did tear all to hell and back. inside, out, up through my clit, back to my anus, deep inside all over the place..basically, it was like a grenade had gone off in my vagina. 9 lb babe, 15 inch head with NO molding, almost completely fused skull, no "soft spot" to speak of.....Basically, it was skull versus vaginal tissue and skin....and the skull won, LOL!

It took about 10 months to heal to a point where i could have sex again, and now things are fine.

In the hosp, it would have gone SO differently....i would have had drugs, i would have been on my back, i would surely have torn INTO my anus inthe damned McRoberts position...possibly, babe would not even have come out without me being in a full standing squat.

Anyway..i guess my gist is that as long as babe has enough room to get through your bones, the tissue will stretch, or if it has to, it will tear.

I woudl say that regardless of where you go......do not for any reason assume a laying down/lithitomy/mc Roberts/ supported semi-squat (which actually makes the pelvis smaller) type position. Hands and knees or full standing squat will definitely give you the best chances, odds-wise, i think.

I'd also take LOTS of fish oil/flax oil, and the last month evening primrose oil, to make sure your tissues are as stretchy as possible.

If you really think you'll tear into your anus and need reconstructive surgery......I'm not sure what to say. Depending on what you see as the value of homebirth, let that guide you. For me, MUCH of the value of homebirth is for the BABY..no drugs, no stress, no poking, prodding, etc.,..so I personally would probably stay at home, then if I had to, transport postpartum (just me not baby) and get surgery done. That way i spare my baby the hospital stuff.
But those are MY priorities....if you intend to get the whoel routine poking and stuff anyway, clearly your deicsion is going to factor in different things that are important to you...

[WinterBaby]

Things stretch amazingly for birth... And even more amazingly, for most of us, they go back. I felt like things were back to where they had been by about 4 months after birth. It's more likely that being new parents is going to impede your sex life more than the actual birthing process will

[cathicog]

Originally Posted by GathererGirl

Thanks for the input everyone! I needed to hear from real people that it's possible for me to have a safe homebirth. Now I just have to convince my husband. As for the perinium thing, it's not that I don't have one at all. It's just very small, and so more likely to tear into the rectum. But f you ladies say it can be done without that happening, I'll believe you. I'm already shopping around for a good midwife, and I'll be sure to bring these problems up with her, too.

the hormones of pregnancy soften the perineum and other pelvic floor tissues and make it less likely that you would tear. Even with a small perineum, if you do a waterbirth and perineal support, and being able to feel how to push so as not to tear, can greatly diminish any possibility of harm.... Go for the homebirth, it is SO worth it. It is what made me decide to become a midwife.

[paquerette]

The pain/discomfort with sex may not be entirely your issues. Is your husband circumcised? That can make sex more uncomfortable for the woman than it naturally would be, cause you to require more lube, etc.

[velcromom]

Originally Posted by GathererGirl

As for the perinium thing, it's not that I don't have one at all. It's just very small, and so more likely to tear into the rectum.

I feel like I have a short perineum too, but I figure I got that from my female ancestors and they didn't have any trouble birthing! That makes me feel better. And I figure, I will reduce my chances of serious tears if I birth in an environment that doesn't restrict my choice of position or interrupt the natural process & hormones. Check out this link about preventing tears -

http://www.gentlebirth.org/Midwife/p...rotection.html

[yogamerd]

Originally Posted by GathererGirl

Thanks for the input everyone! I needed to hear from real people that it's possible for me to have a safe homebirth. Now I just have to convince my husband.

As for the perinium thing, it's not that I don't have one at all. It's just very small, and so more likely to tear into the rectum. But f you ladies say it can be done without that happening, I'll believe you. I'm already shopping around for a good midwife, and I'll be sure to bring these problems up with her, too.

I also have a VERY small perineum GathererGirl. I had a homebirth this past February and did not tear AT ALL. I didn't really do Kegels or perineum massage religiously (just once in awhile when I thought of it). During labor, however, I put hot compresses on my perineum (I actually didn't do this because of not wanting to tear... I did it because it felt good - there was so much PRESSURE "down there" that it helped to alleviate that intense feeling). Also, I gave birth in a birth pool, which probably helped me to not tear.

The only "battle wounds" that I received were MAJOR hemmorhoids. I will not go into detail... let's just say that I have never been so grossed out in my life!

Good luck to you (whether or not you decide to HB). There are a lot of options and I say, if you want to HB, GO FOR IT! Don't let a small perineum stop you! Your body knows what to do!

[faithhopelove]

I have a short perinium as well but it wasn't always that way for me. I tore at my homebirth with Malachi... I had to transport when he was 3hrs old for surgery. Ended up with like 250 stitches inside and out... everywhere. Was SOOOO scared of retearing along my scar tissue when I had my UC with Chloe. I did end up tearing and could have used stitches because I noticed later that what I *thought* was a hemmoroid.. well it wasn't. It's actually a flap of perinium hanging down. It had split and of course I didnt know so it stayed that way. I do worry about tearing into my anus with this next baby since if i do tear... well there isn't much space for tearing.

BUT... if I do tear bad again I would rather tear at home and have to transport than be there just in case. It was NO picnic having to take my new baby to the hosp when he was 3hrs old. But it was still worth having him at home to avoid all other interventions.

Crystal

[Belle]

I was also told by my GP doc years ago that I was very small and would have difficulty in childbearing. She used the small speculum for my exam and everything.

When the time came to actually give birth I had no drugs and gave birth to a baby with a 14.75" head and nuchal hand (hand up near her face on the way out) with only a small tear. I wanted to go back to my old doc and :nana:

[faithhopelove]

Dang I am jealous. lol. Malachi had a nuchal hand as well and I got 250 stitches out of it LOL

[USAmma]

Yep, I was told the same thing and had many of the same issues before my first child was born. Needed the lube and the small speculum and everything.

With my first dd I got a 2nd degree episiotomy, not because I was about to tear but because she was in distress and needed to be born immediately (heart tones in the low 40's and did not recover betwn cx). The OB apologized for cutting me because he said that it did not appear that I would have torn. I was already crowned for several minutes.

With dd2 I told them do not get any scissors near me, I want to see what happens. It was a fast birth. I only tore a tiny bit to one side because my baby came out with her head off center. I did not need stitches and it healed within a week or two on its own.

BTW sex after baby is much better.