Scared of tearing again...

[wwisdomskr]

I've been trying to think about this birth, and realized that I'm terrified of tearing again. :

I tore the first time because I was on my back and pushed too fast and too hard. I knew that I only had seconds to get my baby out before they cut me, in one place or another, to rip her from my body.

I tore the 2nd time because labor was just so fast...

Tearing is so traumatic for me...emotionally and physically. I've had to do so much sexual healing and tearing just makes everything worse... Not to mention the sexual problems that it causes for me...it just compounds everything.

Last time, I ended up pushing on my hands and knees...I needed to be in that position, instinctively, because dd2 had turned her head sideways inside the birth canal...

I tore less at my perineum last time than the first time...but I also tore just a teeny-tiny bit at the top. That hurt soo badly for months.

I'm not sure what to do differently this time. I'm going to stay in the water if at all possible...but, what if that doesn't make enough of a difference?

This is really the only thing I'm worried about...and it's a BIG worry...

[Curlita]

For about 7 years I suffered from vulvar vestibulitis, which basically is a painful inflammation of the vulva. Any kind of trauma, like a yeast infection, would send me into a painful flare for several weeks. I was terrified of what a tear might do during labor. I talked to both my doula and my midwife about it so that they would know that it was a HUGE concern. Here are some of the recommendations they gave me:

--perineal stretching in the months/weeks leading up to birth. You can have your partner do this, do it yourself (sometimes hard to get the right angle), or use a dialator. There is a great section on perineal stretching in the Birth Partner by Penny Simkins. There are mixed reviews on how much this helps, but it can't hurt, right?
--my doula really recommended staying in water to reduce tearing. Even if you don't actually birth in the water, spending time in the water can help.
--if the midwife or OB knows about your concern, they can do things like coaching you on when or how hard to push, applying counterpressure, warm compresses, etc. to try and reduce the likelihood of tears and allow the area to stretch.
--there are some birthing positions that are better than others to prevent tearing, but I don't remember what they are. I seem to remember side-lying as a good one to prevent tears. My midwife also told me that they had noticed more tearing in women who used the birthing chair -- maybe because it sped labor up?

In the end, Dylan's cord was around his neck twice and his heartrate kept dropping... so instead of any pernineal tearing, I wound up with a C-section scar. But hopefully I can use some of these methods this time around, and I hope that something here is helpful to you!

[monocyte]

s

I don't blame you for worrying about tearing again - seems like you had some rough times.

I really think water helped soften me up, even though I was out for DS arrival. My mw also used oil and really rubbed me with it during the pushing (all of about 2 times - he came quick). I vaguely remember hot towels as well - so much of his birth is a blur...it was quick and very intense.

What about doing the olive oil massages pre-birth yourself?

[crunchywannabe]

Jessica, don't worry. a fast birth is not an automatic tearing episode. ALL my births have been lightening fast and I haven't torn because of that.

You need to make sure that your health care provider will stretch/massage your perineum as you are pushing. warm compresses with oil are very beneficial to helping your skin stretch during the pushing.
also, trying to make sure you are controlling your pushes and listening when they tell you to slow down or stop is very important to this too.

((hug))

[Isaac'sMa]

Originally Posted by crunchywannabe

You need to make sure that your health care provider will stretch/massage your perineum as you are pushing. warm compresses with oil are very beneficial to helping your skin stretch during the pushing.
also, trying to make sure you are controlling your pushes and listening when they tell you to slow down or stop is very important to this too.

((hug))

I had compresses, the olive oil massage etc and I still tore (2nd degree)
Jessica, I am SOOO worried about this too. I REALLY do not want to tear again even if my healing was not as rough as yours sounds... For me, I think a lot of it was emotional and not wanting to open up/let go to birth my son. For a number of reasons, I don't think I was emotionally willing that dh really wanted a child at that point in our lives. It makes me sad to type that and I've never said it out loud, but for me I think that's why I tore. I will be working on some of the emotional components of labor this time well before the actual birth. Even though that wasn't part of your reason for tearing, it occurs to me that you might hold back emotionally ( and therefore physically) because you are scared to tear, so it might help you to think about the emotional component too. Just a thought.

Sorry for the OT blabbing about my labor/birth but I know how you feel. Tearing is scary. I'll be staying in the water as long as possible this time too...

[Surfacing]

I'm not in your DDC, and I don't have any new wisdom to add here (OP have said what I know too about preventing tearing), but I too am scared of tearing again.

I had a third degree tear because the BLEEPIN' OB who intervened (midwife had to transfer care) gave me an episiotomy and pulled dd out really fast. Fargin' icehole.

Reading some other responses here helps me to understand that you really can tear under many circumstances. Here's to stretchy tissues and slow crowning for us all. I think it's valuable to discuss your fears with your midwives so it's out in the open and above-board.

[kathteach]

I had a 3rd degree tear and I'm scared too Jessica. My OB said just because I tore before doesn't mean it will happen again. Then he said if I am really worried I could have a csection. Part of me was like "oh, really?" but I don't want to do that.

I don't know what to say. I'm sorry for all you had to go through. I want you to know you're not alone in your fear. And I hope that you will continue to express your feelings about it to us because we want to support you. I am here for you mama.

[Kontessa]

Wow, a fear I do not really have. I have always torn some with each of my 5 births but honestly when it comes to pushing, I am fast and baby flys out. I DO NOT WANT to slow down at that point. more fearful of the pain and out of control feelings then and want to get them over with. I can tell you that for me having my love stretch me lots before really helped!


I agree though, it could me emotional and I know I have things to work on before this baby comes.

[crunchywannabe]

Originally Posted by Isaac'sMa

I had compresses, the olive oil massage etc and I still tore (2nd degree)
...

was it a first birth? you are more likely to tear then anyway. where jessica has had several kids, she has a better chance of not tearing now because her body has done it before, especially if she does the ideas I listed.

Jessica, I tore with my first (and had the episiotomy ) and only tore the slightest with my second. and such a minute tear with my 3rd that I didn't even need stitching at all.

with my 4, 5, and 6 my ob did the massage, and I haven't torn at all with them.

Good luck.

[lisalulu]

Me too! I had an episiotomy last time too because ds's heart rate started dropping really fast at the end. I think I tore on top of that because it was 3rd degree at the end and my midwife felt sooo bad about it. Tearing is defintely one of my biggest fears about birth again!

[boogiemonster]

Another third-degree tear here. You get all of my support, mama. I couldn't sit comfortably on our kitchen chairs for at least eight weeks. I also got a bladder/kidney infection (e-coli, they told me at the hospital - lovely) that I didn't recognize since I was already traumatized and in pain. A super-tactful nurse asked, "Weren't you in pain?", and I said, "Uh, yeah, did you see all my stitches?" Sheesh.

, mama. Hoping everything goes totally smoothly and gently for you.

[crystalalene]

You don't know that you will tear this time.
Do your kegels, too!! It helps you have control and awareness of the muscle so when it's time (the ring of fire) you know you can relax it.

I am afraid of tearing this time, although I did not the first time around, and that hurt enough for me!! The ob did hot oil during the pushing, too. Who knows what makes it work but you can do all that you are able to prevent it, and feel prepared, right?

[GinaRae]

The water is supposed to provide just the right amount of natural resistance and help prevent tearing, as well as relax you during pushing. As the PP said, you don't KNOW that you will tear!

I had an episiotomy with #2, and little tears that weren't stitchable all over with my third. THAT was definitely trauma and the episiotomy seemed to take years to get over.

I am planning on no tears and no episiotomies this time. I just don't visualize them and refuse to give in. But I can see why that might not be so easy for you -- I live in a state of perpetual and blissful ignorance sometimes

[sorteep]

OH dear, I am so sorry.. I definitely can relate and understand.. I have nothing to add except my two experiences.. 4th degree lac with DS1 following a BRUTAL "pressure" right medial lateral episiotmy, nerve damage etc.. I had a LOOONG tough recovery (incontinent #1 and #2 for a good time..) and I KNOW the "situation" somewhat contributed to my 1st divirce (DH1 just did not GET the pain I was still in after over a yr..) DS1 had severe nuchal cord and needed out ASAP and had to be intubated to be ressucitated so I was not mad/ angry/ upset with OB I knew he had to do what he had to do to get him out alive. DS1 was fine but I wonder if some of his ADHD type stuff might be somewhat related to the O2 deprivation..

DS2 3rd degree lac with medial episiotomy.. (lots of scar tissue) precipitous birth, another TIGHT nuchal cord and needed out asap.. OB tried very hard to avoid epi but , again, had to get him out.. I understood and carry no resentment to docs.. recovery easier but still tough

soooooo I tell all this to say I UNDERSTAND your worry/ fear. I am right there with you.. I have heard the anterior tears are the most painful.. many hugs to you .. I wish I had something to say to allay your fears/ and mine but I don't .. all I can do is be here , in the same boat and pray for both of us.. and try to "let go" of my fears because it will be what it will be.. I know I will heal. (mostly, anyway). eventually, no matter what.. many many hugs..

[GinaRae]

I was just reading this thread http://www.mothering.com/discussions...d.php?t=721046 and thought you might find something useful there.

I know your other situations dictated themselves, but this time you may have more control.. SO someone mentioned slow, small pushes when the baby reaches the perineum as well as not pushing at 10cm until you actually feel the urge to push.

That's something that I have learned about in all my births and plan to really put to action this time. I will not be pushing until my body tells me so, not just because I am 10cm. I felt that urge.. the wild, primal, I need to push urge with my second son (he was my first vaginal delivery) and I pushed him out in seven pushes.

[mittendrin]

Originally Posted by GinaRae

I know your other situations dictated themselves, but this time you may have more control.. SO someone mentioned slow, small pushes when the baby reaches the perineum as well as not pushing at 10cm until you actually feel the urge to push.

That's something that I have learned about in all my births and plan to really put to action this time. I will not be pushing until my body tells me so, not just because I am 10cm. I felt that urge.. the wild, primal, I need to push urge with my second son (he was my first vaginal delivery) and I pushed him out in seven pushes.

Same here. With my 1st I pushed when they told me to. I tore, but needed only a couple of stitches and it was speedy recovery. W my 2nd I pushed when I had to and slowed down when my mw asked me to. I had some skidmarks but didn't even need an icepack.

I did do a massage w perineal massage oil faithfully 3x a day for a few months w ds1 until I heard later that it really doesn't help all that much. Don't know about that - everybody says different things about it. I didn't do it w ds2 and nothing happened.

I hope you can relax a bit more about the issue. I can imagine when the time comes to push the baby out and you are freaked out about tearing - you will tear.

[wwisdomskr]

Thanks for all the great advice and support, Mamas.

I know that with my first I forced her out before my body was fully ready. But, with my 2nd, the urge to push was so overwhelming...I don't even remember really doing anything... It felt like dd2 flew out of me...although it was a little tough because her head was sideways.

Dh and I did the prenatal peri massage the first time...although not for long because dd1 was 2 months premature.

With dd2, I had such a hard time staying pregnant till 37 weeks...so I felt like I couldn't do anything related to giving birth, kwim? I think that was a mistake. My mws did use hot compresses on me...although I can't figure out how they had time... I didn't feel it, I just remember hearing dd1 say "Move your hand! I can't see!" and one of the mws said "Mommy needs me to do this to help her..."

I'm going to speak with our mw about my fears next Tuesday. I really hope that the water will help... I'm thinking about asking my team to remind me to keep my own hands on my perineum, as well. This way...maybe I can be a little more conscious of it and stay "in control" more.

I'll be doing more research... I'll be sure to share what I find.

[wwisdomskr]

Originally Posted by GinaRae

I was just reading this thread http://www.mothering.com/discussions...d.php?t=721046 and thought you might find something useful there.
.

Thanks for the link, Gina!

[crunchywannabe]

Originally Posted by wwisdomskr

Thanks for all the great advice and support, Mamas.

I know that with my first I forced her out before my body was fully ready. But, with my 2nd, the urge to push was so overwhelming...I don't even remember really doing anything... It felt like dd2 flew out of me...although it was a little tough because her head was sideways.

.

you know, I do think that your tearing sounds normal...with a first I think it is more normal, and with your second, with her head not being in the right way-that would cause you to tear some too.

I say that in hopes that it eases your fears some. I would guess that you might have an easier time this time :

[wwisdomskr]

Originally Posted by Curlita

--perineal stretching in the months/weeks leading up to birth. You can have your partner do this, do it yourself (sometimes hard to get the right angle), or use a dialator.

Erica,

What's a dialator? And where would I find one? Have you ever used one or known anyone else who has?