Often touted as something to be feared, perineal tears are a common, and sometimes unavoidable hazard of giving birth. However, tears do heal, and they are something you can actively minimise.
The routine use of episiotomy, is unncessary, especially when it is performed in the name of protecting the perineum. A natural tear, will go through skin, and many less layers than the episiotomy, which cuts through into the muscular layer.
A natural tear will often heal faster than an episiotomy, often not even requiring stitches.
Natural tears are often less painful than an episiotomy, whilst healing, on account of the fact there is less swelling, and less stitching (less layers to stitch)
Preventing tearing, or at least minimising it, is something you can actively prepare for.
Prior to labour, you can practise perineal massage, and oil the perineal area with olive oil after showering or specialized perineal massage oil.
Allowing your body the optimum chance to stretch slowly, will help avoid a tear. As the baby’s head is crowning, don’t push conciously - it will often come down, and go back up again, giving your perineum plenty of time fan out and accomodate the baby’s head. Breathing the baby out is often a
9lb 6 oz, intact perineum!!
technique taught to birthing women.
The hospital policy of coached pushing is a recipe for perineal damage. Especially when combined with supine positoning (flat on ones back, or with feet in stirrups)
Your best option is to trust your body, and go with it’s urges. Push when you feel the need, stay upright, and move as you feel you need to.
