Avoiding tear with upcoming birth?

[Lohagrace]

I'm sure this has been discussed, but I couldn't find it. With my first birth, I had a 3rd degree natural tear. This is probably because when her head started to crown, i just pushed as hard as i could and ignored the midwife and OB telling me to slow down, etc. I had been in labor for 50 hours and i was DONE. so after her head crowned, the rest of her shot out--literally flew out all at once. So they did stitch the tear. I didnt find the recovery to be terrible and i havent noticed any problems from it.
My question is, do i need to do anything with this upcoming birth to prevent another tear. i dont mind a little tear, i would rather avoid a 3rd degree, though. I don't want to have a frankenass again I'm planning a natural, intervention-free hospital birth with a midwife and a doula. I've heard you just shouldn't do anything (except maybe don't push quite so hard this time!) or to use oil or something. Should i try perenial massage now? any advice appreciated.

[lizabird]

Sounds like your experience was veyr similar to mine. 3rd deg tear, natural birth (but mine was in a birth center and I did a water birth), I pushed mightily and baby shot out all at once. I was worried about another tear with baby #2 and talked with the midwives about it quite a bit. Anyway, I recently had baby #2, another birth center water birth, and had a small tear with really fast recovery. I think the difference was that my midwife was very very aware of my NOT wanting to tear and she was doing everything she could to help prevent it, with my positioning, slowing down pushing as baby was crowning (which I wasn't sure I'd be able to do but it was actually pretty easy to do), etc. So defninitely talk with your birth team and express your concerns and see what they suggest for you. Good luck!!!

[stacyann21]

I agree, talk with your m/w. There are several things you can do to reduce your risk of tearing. Perineal massage starting at week 36 can loosen and relax the perineum for birth. Your m/w can help you with slow, controlled pushing as well as using a warm compress to relax the area. There also certain positions that are better to prevent tearing such as side lying or on all fours. Good luck!

[bobandjess99]

There are options..some say perineal massage helps, others say it actually makes it worse...using oil, internally and orally is also an option...waterbirth is said to help, using very hot compresses during crowning, crowning slowly over several contractions, not being in a lithotomy position....

That being said, i did ALL of that..massage, oil the last month, water laboring, hot compresses during crowning, manual support during crowning, letting baby sit on perineum for like 3 contrax before pushing, etc...and i tore from stem to stern.
I really think a LOT of it is genetic...sort of like stretch marks, LOL!