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advice needed on helping out my poor perineum!

post #1 of 24
Thread Starter 
Hi! I'm due with #2 in May and my only concern surrouding this birth (our 2nd UC) is my perineum . I tore with my first (his shoulders did it, we think and it's either a 2nd or 3rd degree) and it didn't approximate although I have had no problems resulting from it. Sex is hunky dory (or as hunky dory as it gets when one is sleep deprived and has a fireball toddler ) and I've had no problems whatsoever with bowel movements (tmi, sorry). So everything I hear about birthing after such a tear makes me afraid I'm gonna have bowel incontinence for the rest of my life: .
Anything I can do to prevent this? I've tried to remember to keep doing those Kegels since ds's birth and I've been applying a homemade cocoa butter salve to the area. Any advice or positive input would be appreciated! I'm feeling sooooo paranoid!! Thanks in advance!!:

jiva
post #2 of 24
I hardly ever post here but this one I wanted to answer because I too have a perineal tear that healed, um, not badly, but let's call it "differently". I don't know what degree it would have been called, though I'd love to know, but basically my perineum split all the way down to the rectal muscle but not into the muscle. It healed open, meaning my perineum is a 'V' now and the bottom of the 'V' basically touches the top of the hemmorhoid I got pushing out Baby #1 (with whom I tore).

Same as you, no BM problems and sex was actually better after the tear healed, but when I came to having Baby #2 I was a tad worried that it would tear again, because there really wasn't any more to tear, yk? (BTW, Baby #2 was born 21 mos after Baby #1) What worked for me, or I assume it worked because I didn't tear again, was every single night (and I really mean I didn't miss a one) from 32 weeks onward I rubbed avocado oil into my perineum before I went to bed. I didn't do the whole "massage your perineum and stretch it out for 10 minutes" and all that yaya that they describe in the official "how to perineal massage" blurbs, just poured some into my fingers and slapped it on/in there.

Baby #2 weighed about the same, or slightly more, than #1, and came out in three pushes. My yoni was fine after, not even swollen.

So that's what worked for me, avocado oil.

HTH
post #3 of 24
I had an episiotomy with my first that took over a year to finally 'heal' so, I had similar concerns about my perineum w/my next birth. I had my subsequent two in the water, and it's the water that I believe really helped. I also maintained pressure on the area with a washcloth (wet of course being as it was underwater ). No tears with either of those two--and both were exactly two pounds heavier than my first... scissors :
post #4 of 24
Quote:
Originally Posted by beebaweewa View Post
I hardly ever post here but this one I wanted to answer because I too have a perineal tear that healed, um, not badly, but let's call it "differently". I don't know what degree it would have been called, though I'd love to know, but basically my perineum split all the way down to the rectal muscle but not into the muscle. It healed open, meaning my perineum is a 'V' now and the bottom of the 'V' basically touches the top of the hemmorhoid I got pushing out Baby #1 (with whom I tore).
Thank you for sharing! THIS is what happened to me after my second dd's birth, except not quite that far, and I never knew how to describe it before. So thank you for describing that so well.

For the record, I had no tearing or problems with my 3rd dd's birth and I did nothing special to my perineum to prepare.
post #5 of 24
I was totally paranoid about tearing with this baby, too.

I had a huge episiotomy with my first one which tore at the end, so it ended up being like a four-inch long incision that ended down my butt cheek. It was horrible and took months to heal.

I didn't do anything special this time and I still tore a little ---two small tears above my urethra and then a 2nd degree vaginal tear.

I was totally scared that I would tear again over my episiotomy site, but I didn't. Additionally, I was worried it would be way worse or hurt as bad as the episiotomy, but it didn't even come CLOSE.

The small tears I got this time were waaaaaayyyyyy better than the episiotomy.
post #6 of 24
Quote:
Originally Posted by beebaweewa View Post
I hardly ever post here but this one I wanted to answer because I too have a perineal tear that healed, um, not badly, but let's call it "differently". I don't know what degree it would have been called, though I'd love to know, but basically my perineum split all the way down to the rectal muscle but not into the muscle. It healed open, meaning my perineum is a 'V' now and the bottom of the 'V' basically touches the top of the hemmorhoid I got pushing out Baby #1 (with whom I tore).

HTH
Very interesting! My perineum didn't heal quite like that, but it keeps getting shorter with each baby (I ended up getting stitches both times). I have almost no perineum left in that area! I wonder how many other women experience this?
post #7 of 24
Quote:
Originally Posted by augustacherri View Post
Very interesting! My perineum didn't heal quite like that, but it keeps getting shorter with each baby (I ended up getting stitches both times). I have almost no perineum left in that area! I wonder how many other women experience this?
This is interesting, and thanks for sharing, because I've never been too happy about my perineum and have assumed it would have gone back to normal if I'd had it stitched. Functionally, all is well, but esthetically I'm not so cool with what things look like post-tear. But then I've often wondered if part of it is just due to having had a baby, like maybe all perineums look different (not so pink and pretty) after giving birth? I've wanted to find out about this but "What does your perineum look like?" isn't something that normally comes up in conversation, yk?
post #8 of 24
Well, I guess here's as good a place as any....

My girly parts are totally different since I had my first baby. First of all, the perineum is shorter at the bottom, but after this second baby, I had two tears up by my clitoris. One side was a small skid-mark like tear on the skin. The other one tore through my labia minora and it has not grown back, so now I have this little separation between my clitoris and that part of tissue. It's all healed, but didn't close back up. It doesn't make any difference in the way things feel, but I have thought about how it looks asthetically---I guess it doesn't matter too much since DH and I are the only ones that see it

But still, my body has changed ALOT since I had the first baby. Everything still works just fine, though....
post #9 of 24
Thread Starter 
Thank you soooo much everyone! I know, I know, this isn't something you wanna talk about every day but I reaallly appreciate it. : I keep reading/hearing about bowel incontinence after such a tear as mine and it's really been freaking me out! Beebaweewa, you described my perineum exactly! Never thought I'd say that. But yes, that's what mine looks like and yes, I feel like there's nothing left to tear, except, um, what I reeeeaaaally don't want to tear...not that I wanted my perineum to though. It's my one regret from my first birth. I just pushed the shoulders out to fast and wasn't too good about keeping my legs together for a week. :
Ds was 9 lbs so I'm hoping for a smaller baby this time and maybe he/she'll just slide right out like dh tries to cheer me up by saying. : Thank you again everyone. You ladies rock for sharing this with me/us!!!

jiva
post #10 of 24
What I've noticed makes the most impact on women's perineums is their nutritional status. GOOD NUTRITION= Good tissue and skin integrity. EAT WELL! EAT oils.... good ones like virgin olive oil and coconut. Take fish oils and evening primrose oils.... add flax seed to your diet.... use it in baking, grind it into smoothies..... KEGEL< KEGEL< KEGEL!!!!!!
post #11 of 24
Quote:
Originally Posted by jiva View Post
Beebaweewa, you described my perineum exactly! Never thought I'd say that. But yes, that's what mine looks like and yes, I feel like there's nothing left to tear, except, um, what I reeeeaaaally don't want to tear...not that I wanted my perineum to though. It's my one regret from my first birth. I just pushed the shoulders out to fast and wasn't too good about keeping my legs together for a week. :

jiva
Heh, heh, kinda nice to know I'm not the only one with a perineum quite like that. I did basically the same thing, his head came out and he sat there for a minute, which was really not a great feeling, so as soon as he started rotating I blasted him out (seriously, he shot out fast) I used to feel similar to you, that I should have been more patient/careful. The thing is, I really felt compelled to get him out of me and I'm a firm believer in the 'rightness' of instinct. So I came to the conclusion that if I felt the need to get him out that fast then it's because he needed to be out that fast; and if I needed to tear to get that done then so be it. I also believe that if an unhindered woman tears in the process of giving birth then it's most likely because it was the only way of getting what needed to happen to happen.

I totally understand the feeling of looking at what's left down there and thinking that if that tears I'm really gonna have the kind of problem that requires medical attention. (I'm pregnant again so this has been on my mind lately.) One way to look at it is that whatever needed to give already gave, and the opening you need to get this next baby out of is a bit bigger than what you had to work with last time.

There are also some people who believe that the perineum is meant to tear, kind of like the hymen, so it's not something that's meant to go back together once it's split. If you think about it, you and I both had first babies UC and this happened. And despite the esthetics of it, and the many warnings foisted upon women by the popular birthing culture, neither of us has any functional issues. Maybe the 'V' perineum is just another variation of normal and if UC were the norm then many women would have perineums like this and it wouldn't be seen as something to worry about.
post #12 of 24
Just so you know where I am coming from, we've only had UCs. With ds, I tore forward and backward. I didn't realize at the time, but I tense my muscles in everyday life. I've worked on it since realizing that.

When I was birthing ds, I was in a semi-squat (knees slightly bent), hands on the bed supporting myself. Dh was behind me to catch since I wasn't in a good position to catch. Ds's head came out and he blinked his eyes open and was watching dh. Dh said, "Don't push." In a fraction of a second I thought how he had been doing so well up to that point and why did he have to go and say that? Then next thing I knew was a voice in my head saying PUSH! in a very urgent tone. So, I did, and ds shot out. Not until much later (months) did dh's side come out. Apparently he saw that ds's shoulder wassticking halfway out, so was reaching up to help when he said don't push. My belief is, that with ds watching him, ds realized that his birth should not be hindered even for one minute with a UC-supportive father, and that the coice I heard in my head was ds telling me to push him out right then.

With dd - I birthed, I caught, dh and ds watched. I relaxed my muscles. I did not tear at all.
post #13 of 24
Quote:
"What does your perineum look like?" isn't something that normally comes up in conversation, yk?
So true I've learned so much around here that I would never have heard about even amongst my IRL closest friends
post #14 of 24
Quote:
Originally Posted by boheime View Post
Just so you know where I am coming from, we've only had UCs. With ds, I tore forward and backward. I didn't realize at the time, but I tense my muscles in everyday life. I've worked on it since realizing that.

When I was birthing ds, I was in a semi-squat (knees slightly bent), hands on the bed supporting myself. Dh was behind me to catch since I wasn't in a good position to catch. Ds's head came out and he blinked his eyes open and was watching dh. Dh said, "Don't push." In a fraction of a second I thought how he had been doing so well up to that point and why did he have to go and say that? Then next thing I knew was a voice in my head saying PUSH! in a very urgent tone. So, I did, and ds shot out. Not until much later (months) did dh's side come out. Apparently he saw that ds's shoulder wassticking halfway out, so was reaching up to help when he said don't push. My belief is, that with ds watching him, ds realized that his birth should not be hindered even for one minute with a UC-supportive father, and that the coice I heard in my head was ds telling me to push him out right then.

With dd - I birthed, I caught, dh and ds watched. I relaxed my muscles. I did not tear at all.
That was my first birth too. I had a MW. She told me "don't push", but I did, cause I was going to birth when I wanted, even if I got all tore up.

So now it's kegel, kegal kegal for me.:
post #15 of 24
Thread Starter 
Quote:
Heh, heh, kinda nice to know I'm not the only one with a perineum quite like that. I did basically the same thing, his head came out and he sat there for a minute, which was really not a great feeling, so as soon as he started rotating I blasted him out (seriously, he shot out fast)
I hear you...dh says he almost didn't catch ds 'cause he flew outta me. But to my defense , I had pushed for 3 hours, ds was posterior and after his head was out I asked dh if all was ok...he said, "uhhh...". So all I could think was that he was stuck or something and since things still hurt like &*%$ anyway, I pushed. :
I'm sorry we all have tears and worries about them...but I'm also really glad to know I'm not alone. I hope that's not selfish of me. I wonder sometimes, as a pp mentioned, that what if this is normal...and while I know lots of women out there don't tear, a lot do. It's like out mark of motherhood.
I am going to keep rubbing on that salve I made and I have been eating tons of flax muffins...I crave them when I'm pregnant and nursing, otherwise, bleh! Oh, and I'll keep well-hydrated...which would be easier if someone one get off my bladder! :
Oh and congrats on the new little one, beebaweewa!
Thanks all!

jiva
post #16 of 24
Another UC first birth and a tear here! My perineum proper has never torn, and I tend to feel all the burning up front NEVER in the rear.

Anyway, my first baby shot out too, and I've always wondered about "if I had been more patient" but in retrospect, the placenta flew out immediately after baby followed by soaking blood~ pads, clothes, couch for an hour or so after birth, so I'm thinking the placenta had separated and it was a necessary evil to PUSH baby out.

In anycase my labia tore on the side and I didn't bother to recup slowly (bad mama!) and it healed, but not together. I always wonder what a doc or nurse would say if I ever needed to see one.....like if they would feel the need to say something about it. It's never really bothered me. Sometimes it can get a little irritated after sex due to friction, though I guess that's possible anyway, LOL.

I was really concerned when preg with #2 since there really wasn't anywhere for the tear to extend, but all was fine. I had a small tear next to my clitoris that time, but it healed cleanly, and then FINALLY after #3, no tears, no hemmorhoids, just some swelling that subsided after a day or two. I guess our bodies eventually get the hang of it!

Kat
post #17 of 24
I love this thread. I have been so insecure about my perineum since my second birth and I love hearing that I'm not alone.

Quote:
Originally Posted by beebaweewa View Post
So I came to the conclusion that if I felt the need to get him out that fast then it's because he needed to be out that fast; and if I needed to tear to get that done then so be it. I also believe that if an unhindered woman tears in the process of giving birth then it's most likely because it was the only way of getting what needed to happen to happen.
I totally agree. My second dd SHOT out of me. It wasn't a UC but my midwife was very hands off and wasn't coaching me to slow down or anything. Anyway, my dd was wrapped up in her cord which, I am convinced, is why she was in such a hurry to get out. It worked out.
post #18 of 24
It sounds like such a funny thing to be insecure about, but I'm a bit insecure about my pernieum also. At my first birth (I moved around during labor, but when I arrived at the hospital the medwife had me lie on a bed and directed pushing), I had a second degree tear. My second birth (which was a UC, jsut three months ago), I tore a little at the same place, and also above my vagina. I also had a slight bladder, uterine, and rectal prolapse. Not cool. Which all made me wonder if I'd really like to have more kids. A water birth would be nice next time, but my labor and birth was only 2 hours long, so I don't know if we could get it set up in time to be of assistance! Anyway, I'm glad to hear the discussion.

Is it just fat that helps strengthen the tissue? I'd imagine that quality protein would help too, and am wondering if any other dietary measures would help.
post #19 of 24
Quote:
Originally Posted by rajahkat View Post
Another UC first birth and a tear here! My perineum proper has never torn, and I tend to feel all the burning up front

In anycase my labia tore on the side and I didn't bother to recup slowly (bad mama!) and it healed, but not together. I always wonder what a doc or nurse would say if I ever needed to see one.....like if they would feel the need to say something about it.
Kat
I went to the doctor (for foreign birth certificate reasons) two days after my UC and she stitched the 2nd degree vaginal/perineal tear I had down low (it was still open and bleeding alot). But she said there wasn't any reason to stitch the top labial tears. One healed together, one didn't. Since she didn't see any reason to stitch that, I'm assuming that OBs probably see all sorts of things that like. I mean, think about it....our yonis don't all look alike before birth. I'm sure there's a large variation on normal before and after birth. I am kind of glad that my upper tear didn't heal back together---that much more room for the next baby, right?

Oh yeah, my sister who has had two babies and also had stitches both times (hospital births; 1 episiotomy) has the "V" perineum, too. She was glad to hear about our little discussion here and that she wasn't the only one!
post #20 of 24
I tore w/ my 1st. My 2nd was a UC and I did my own perineal support. I also breathed instead of holding my breath and made sure that I didn't help my body push any more than I had to (I get an OVERWHELMING urge). I think I had a tiny tear or skidmark, because it burned when I peed the first day. After that, everything was fine
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