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What about tearing?

post #1 of 68
Thread Starter 
I birthed my son at a birthing center with a mw and a doula. The mw turned out to be more of a MEDwife and was very pushy and rude throughout my labor! She also did not respect some parts of my birth plan. Anyway, I'm already entertaining the idea of a UC for any future babies. However, during my birth with ds I had extensive tearing involving skin and muscle. The mw sewed me up with several stitches and for this reason I was very glad she was there. What do you do if you tear badly during a UC? Certainly you can't stitch it yourself and I would hate to have to go to the hospital right after giving birth and in so much pain down there!
post #2 of 68
It is very unusual for a woman pushing when she feels the need (instead of when directed) to tear seriously.

-Angela
post #3 of 68
I tore badly with my first (a midwife attended fsbc birth) and got a lot of stitches. I fully believe it was the positioning THEY put me in and the directed pushing that caused all of the problems. My daughter had a nuchal hand and my instincts were to push standing up which I think would have been much much better. With my second I had midwives but they were much more hands off and I was in charge of pushing. I was standing and would push and squat and then stand more when it burned. I eased him out with only a small tear that actually repaired some uncomfortable scar tissue. With my third (UC) I gave birth in water and I did tear again. I have no idea how bad it was as I never looked at it. I kept my legs together and let it heal naturally. It took about 7-10 days to heal up and is totally fine now. I had a relationship with a midwife at the time that could have come and done a repair if necessary and that is what I want again, a UC friendly midwife that could do a repair at home if necessary.
Wendi
post #4 of 68
Thread Starter 
So basically, you just cross your fingers that you don't tear? I was allowed to push how and when I wanted and I still tore very badly.
post #5 of 68
Quote:
Originally Posted by stacyann21 View Post
So basically, you just cross your fingers that you don't tear? I was allowed to push how and when I wanted and I still tore very badly.
If you philosophically believe that the human body births best without assistance, then it follows that any tearing that happens is natural and will heal

IMO most tearing doesn't need stitching (the exception is real damage done by forced pushing in bad positions. Not speaking of course of cutting)

-Angela
post #6 of 68
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post #7 of 68
Quote:
Originally Posted by stacyann21 View Post
So basically, you just cross your fingers that you don't tear? I was allowed to push how and when I wanted and I still tore very badly.
Is it possible you were pushing before your body was ready? How did you decide when to start pushing, and how? I don't mean to grill you, it's just that tearing through muscle is virtually unheard of when pushing is spontaneous and instinctive. It's the forced pushing on a body that hasn't had time to ready the tissues for the passage of the baby that causes injury. That said, "pushy and rude" isn't exactly conducive to normal functioning of the body in birth. I'd guess that with you in a supportive and undistracting environment your body will produce the hormones that make the tissue resilient and birth the baby at the best time to avoid trauma to your body.
post #8 of 68
If I tear with this upcoming UC, I plan on using natural methods to heal it. Seawead, comfrey compresses, etc. There are some good tips written up on this essay HERE.

I had a 3rd degree tear (along with an episiotomy : ) with my first, so I'm really hoping to avoid that this time. I'm sure my completely medicalized birth didn't help matters.

Also, keeping up a good diet, and adding certain vitamins/herbs (other people may be able to chime in on which ones) can help with skin elasticity.

And I think following your instincts and birthing in the position you feel most comfortable is very important, as well
post #9 of 68
I had a 3rd degree tear with my first baby. I had a totally undirected labor and pushing stage. For all my body knew, it could have been a UC. I was also in the water.

I got stitches. There was no way I was going to lie in bed with my legs together for a week or two. Nobody has been able to give me useful tips on avoiding tearing next time. Except that if I do everything naturally, it won't happen. But of course that doesn't necessarily apply to me.

As for what you can do, perhaps you could line up a midwife beforehand whom you could call to come to your house and do stitching if necessary.
post #10 of 68
I didn't just cross my fingers. I pushed in a way that I thought was gentle and easy and non directed by others which minimized my chances and I also established a relationship with a midwife that could do a repair at home so that I wouldn't need to go to the hospital and get separated from my baby. I planned a UC to minimize interference and keep myself and my baby as safe as possible.
Wendi
post #11 of 68
Of course there are exceptions to every rule, but I just have to point out that undirected pushing doesn't necessarily equal instinctive, involuntary pushing. Any time you are pushing beyond what you are compelled to do beyond your control, you are risking pushing at the wrong time and in the wrong way.

I would have had a hard time staying in bed too, and if I'd torn into the muscle I would have had a midwife come and stitch me up. If that wasn't possible, I'd go to my family doctor who attends births. No, it wouldn't be pleasant to have to go to the hospital right after birth, but the possibility wouldn't prevent me from having a UC.
post #12 of 68
Super glue was originally created as a way to repair body trauma in lieu of stitches. I've heard of midwives and others who still use it for that purpose.
post #13 of 68
I tore with both of my UCs (I ony got a tiny skid mark w/ my hosptial birth, go figure). I have never done directed pushing. I have only pushed when it was impossible not to and it's not something I have been able to control though. I'm not sure how badly I tore this last time but I do think I would have maybe healed better if I had been stitched (maybe I would have more perinium left ). I should of let the midwife I was seeing check me out and stitch me if needed. But I really just didn't want to be messed with, I regret that now.
post #14 of 68
As far as stitching yourself.....well, the more I read, the more inclined I am to feel anyone can learn to do this. Anne Frye has a book, I believe it's called healing passage and a video guide to suturing if anyone wants to check it out. I know for some, stitching oneself up or having someone else in your family do it may seem extreme. To me, it's not. It's more about being prepared, since I hopefully will be living on the side of mountain someday FAR from society.....sigh.....dream......and surely the kids or the hubby or I will eventually get cut.
post #15 of 68
Quote:
Originally Posted by stacyann21 View Post
What do you do if you tear badly during a UC? Certainly you can't stitch it yourself and I would hate to have to go to the hospital right after giving birth and in so much pain down there!
in both my hospital birth (directed, count-to-ten pushing) and my uc birth (spontaneous pushing), i sustained minor tearing. at the hospital, the cnm put in a single stitch. at home, i let the tear heal on its own. so, i honestly don't believe that, outside of extraordinary circumstances, i'll tear badly, if at all, with my next birth (i'm 25 weeks along now).

with that said, if i tore into the muscle, i'd get stitches. ideally, via a uc-friendly midwife who'd come to my house. but, if i had to, as much as it would suck to, i'd go to the hospital. muscle damage during birth is not natural damage, and i wouldn't expect it to heal cleanly without some intervention.

christina in lawrenceville, ga
post #16 of 68
Tearing is a very real possibilllity for any birth. Don't just cross your fingers and hope you don't tear. (I thought that was a funny comment, BTW. ) I had a very peaceful unhindered instinctive birth that resulted in a fourth degree tear. I highly recommend that in preparation for your birth, if you are planning on no PP care, that you or your partner learn about tears so you can tell if you tear (you would think a fourth degree tear would hurt, but for me it honestly didn't, and it didn't bleed much either.) Then you should decide beforehand what you are going to do in the event of a tear- questions to ask yourself: do you feel comfortable staying in bed and keeping your legs together for two weeks- would you prefer a couple stitches- do you want to go to the ER or have you developed a relationship with a care provider? I suggest you likewise consider what you will do in the event of any other common situation (I don't really like to say complication, but you know what I mean?)

And should you decide to hire a midwife for PP care, make sure beforehand she knows something about tears.

These are just my suggestions based on my experiences. You may feel the need to do something else.

Happy baby!
post #17 of 68
Thread Starter 
Thank you to those who recommended having a mw lined up to do stitching if necessary. This is what I will do if I decide on a UC next time. I just want to reiterate that my mw did not tell me when or how to push. I actually had a fetal ejection reflex in the birthing tub so my mw checked me and I was 10 cm. I'm all about trusting your body but sometimes tears happen, bad ones, regardless of how you push
post #18 of 68
Second time around things are stretched out alittle more then the first time you gave birth, postitioning is key, maybe some "romantic" massage before hand can help you to feel comfortable with the sensetions and help the skin to be plyable(sp sorry)
post #19 of 68
For the record, I don't think putting superglue on a sensitive yoni is a good idea. At least, it is not something I'd be willing to try! Maybe I misunderstood that comment?
post #20 of 68
Quote:
Originally Posted by stacyann21 View Post
Thank you to those who recommended having a mw lined up to do stitching if necessary. This is what I will do if I decide on a UC next time. I just want to reiterate that my mw did not tell me when or how to push. I actually had a fetal ejection reflex in the birthing tub so my mw checked me and I was 10 cm. I'm all about trusting your body but sometimes tears happen, bad ones, regardless of how you push
She checked you because you had a fetal ejection reflex? I really wouldn't have thought there'd be time for a check, or that it would be remotely comfortable to have someone checking you at that point.
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