Reducing your risk of perineal tears

It is relatively common (around 50% of mothers) to experience a tear or graze to the skin and/or the vaginal wall during birth. A small proportion (3% of mothers) experience a more significant laceration which involves the anal sphincter. To some degree vaginal tears are a normal part of the birth process and generally heal very well, however, there are still some factors worth considering in preparation for your birth.

-Perineal Massage: from 35 weeks may lower your risk of an episiotomy and more severe tears. There are diagrams and information booklets about perineal massage available online through most major hospitals, check out the Australian Birth Stories website as they have a great free resource all about perineal massage.

-Birth Position: some birth positions such as all fours, kneeling, and side lying have been shown to decrease the risk of tearing. Other birth positions such as lithotomy (stirrups), squatting, lying on your back semi-reclined have been shown to increase the risk of tearing. Dr Rachel Reed (midwife thinking) has a great blog post on this topic ‘Perineal Protectors?’

-Warm Compress: If you are birthing on land (i.e not in the bath) then a warm compress to the perineum during birth may reduce your risk of tearing. Although if a warm compress involves changing position to allow for this it may actually be counterproductive.

-Breathe Through Crowning: Gentle verbal guidance to assist with a slow and controlled birth of the fetal head and shoulders has been shown to reduce the risk of tearing. Small puffs or horse’s breath and following your body’s own involuntary urge to push can help to achieve this. B from Core and Floor Restore has a great free resource on her website too!