I have been thinking a lot of my upcoming labor and I really want to avoid tearing. I didn't let them "cut" me last time and I did tear. The healing was pretty rough and I would like to avoid it next time if possible. I have been doing Kegals but other than that, any suggestions? Do you think that you are less likely to tear with second births than with the first???

I've kinda been wondering about it the 2nd time around too. I did get an epis. and it still was sore for several months afterwards even when it had healed. BD especially. I'll keep an eye on this thread if you dont' mind, Jill!

I tore a tiny bit with my first but I didnt tear with my secong or third. I dont know if they will do this in the hospital but with my homebirths my midwife uses hot compresses, and olive oil. She did more but I cant think right now.. Tara will have more suggestions!

I tore with my first epidural birth, and NOT with my other natural births; my midwife said it was because with natural labor you can feel and breathe with the contractions, instead of pushing when your body is telling you not to. I have to agree with her on this one... because with my first it seemed like all I did was push, and with my others, I was told to relax when I felt the need and push when I felt like it... then I would get cheerleading WHEN I pushed... midwives are just so different, hun.

I did not have an episiotomy and only tore a tiny bit (I only needed 2 stitches). I think a lot of it is due to my labor nurse. From the time I got there until I delivered, she would stretch it out "down there" with her finger during every contraction. I hated it then, but I was really glad she did it later! I've heard that you can start the "stretching it out" early and it's supposed to reduce your risk of an episiotomy / tearing.

With my 1st I tore a tiny bit (2 stitches). I did kegals before the birth and my doc massaged the area as the baby came out... relaxing the muscles. With my 2nd I had not tear and with the 3rd a small tear... not massaging (I had a diff. doc than with 1 and 2). I talked about Episiotomy with my doc prior to delivery and told her that I wanted to avoid one. She took that into consideration and made the best of it. My healing was quick and I had no discomfort after the area healed. PM for more info if you need it.

I've read and have been told that it is better to tear than to have an episi'. You heal faster and better.
I tore very badly with Abby, but I tore up ward instead of downward. I do believe that hot compresses and olive oil help tremendously while the midwife/doc massage and stretch it.

I'm really hoping not to tear again.

I had an episiotomy and a 3rd degree tear. I wonder if it was bcuz they made me lay down to deliver the baby. I think if you stay upright for the delivery then your body works with gravity and you don't tear as bad if not at all. I will be putting my foot down next time and telling them that I will be staying upright for the birth.

Had a level 2 episiotomy with my first....tore because the doctor didn't get there in time the second birth......HORRIBLE! Healing was terrible, 4x's the amount of stitches and pain.....from my experience, I would TOTALLY vote episiotomy!
I will add that BOTH of my births were all natural....it totally depends on your body, not natural vs. drugs. I had the massage done as well to try and avoid an episiotomy too....no luck.

I only tore a little (2 stiches) they told me that they do not like to do an epis. anymore that you will heal better with a natural tear. I think the nurse massaged as well during contractions. I did hear that you can work on stretching a little prior to birth as well.

I only pushed for about 45 minutes, but I looked at the dr at one point and said why can't it just tear and the baby come out.

I don't know what I would have done had I had to push long term. I guess I am a weenie. :)

In most cases, a tear is going to be less severe than an episiotomy. It is actually rather rare that a woman have THAT bad of a tear. When one does, it can generally be traced back to her pushing AGAINST urges..meaning..not having the urge to push, yet, is pushing forcefully anyway and/or being too flat on their backs.

Being upright certainly does help.

Having an epidural can also affect this as you cannot feel what's going on well enough. You cannot willingly relax yourself down there to allow things to stretch and open up. And again, this leads to pushing because you are told to, not because you feel the need to. Forced pushing is like *the* reason for tearing. (not the one and only, I'm just saying..primary)

Sometimes babies just come so quickly the body hasn't had time to relax and soften, stretch and open up, therefore, she tears. That was my second child. He was only 7lb 8oz but a fast labor, before I knew it, I had to push and he just SHOT out :p I had a 1st degree tear. Again, #3 was a fast labor and I tore along that scar, 1st degree.

As far as being more likely to tear with 2nd or subsequent pregnancies...I wouldn't necessarily say yes or no. It all depends on the child and birth.

Continue doing your kegals. Practice relaxing and opening up down there. You can do perineal massage now as well, though, I never bothered with such a thing, I have heard from many others it seemed to help immensely.
And of course, massage and compresses DURING labor. Being allowed to be upright and active is going to help. Being able to FEEL what your body is doing is going to help.

Generally speaking, an episiotomy is going to be worse than a natural tear. The episiotomy slices through so many layers of tissue. A natural tear rarely goes that far. I know some here have had bad tears...I do not know all the circumstances that led them though. I'm just saying..in most cases, if the woman is not forced, if she is allowed to relax and open up in a comfortable, more natural birthing position, if she tears, it will not be as severe. In *most* cases, a tear can even heal on its own, with no stitching.

I had a homebirth, so not too many worries about an episiotomy as long as I stayed at home, since my midwife doesn't do them. I do lots of squats and kegels to tone the muscles, made sure to eat a super healthy diet since healthy skin stretches better, & did perineal massage for a few weeks before the birth.

We did VERY slow controlled pushing. (I probably let the baby crown for a good 10 minutes before I pushed her out, thus stretching my perineal skin) The midwife applied olive and hot washclothes as well.

Anyway, the end result was that I had a 8 lb, 13 oz baby and didn't tear at all. I'm not sure which thing helped the most, but next time I'll be doing all of them. :)

My midwife did the stretching thing too, and I didn't tear at all. I wouldn't want an epis, because then you'll need stitches regardless. If you don't get one theres a chance you won't. I don't know how good the chance is, but I wouldn't get one.

Then again my little sister tore really bad, took a couple hours to stitch her up. My mom was very upset they didn't do a epis, because the baby was turned the wrong way and it was very difficult to push her out. If it wasn't for my sisters pure will power she would have needed a csection. So I guess in certain situations it might be better.

Thanks, girls! I really enjoyed reading all of the helpful info! Here's to a tear/epis free labor!!!

The ladies have mentioned most things I'll mention...
to avoid episiotomy you will want to:
- be as upright as possible during delivery (equalised pressure)
- perineal massage with warm compresses
- kegals
- push when your body tells you to push (avoid "purple pushing"- so natural childbirth lends itself to this)

Keep in mind that even if you have an episiotomy, it doesn't mean you won't tear... think of pulling on a piece of paper, then make a snip and pull again... what happens?

If you are in a facility that is "cut happy"- make sure that you and your labour support people tell the staff that you do not want any cutting and to watch out for dr getting out the knife.
I encourage you to use the position for birthing that your body wants to use... it is not about the dr's convenience or potential backache. If they ask you to move, ask why and what is the benefit to me or my baby. If it is not medically necessary, then insist that they accomodate you.
In our neck of the woods, births are very heavily medically managed and one must be very forthcoming about ones desires and wishes.

Hope that helps.
d:)

I tore with my first and got 2-3 stitches; it was tender and sore for a while but my doctor said that it was much better for me to have torn than to be cut because they usually cut way more than is necessary which makes healing so much harder. We had also discussed episiotomies before I went into labor and I told hmy doctor I didn't want one (both my cousin and a woman I work with had bad experiences with theirs). With my second I didn't tear at all and I was so greatful!