Is one of your biggest fears of giving birth that you might tear or need an episiotomy?
1 - Avoid Pushing: The first tip and probably the most important one is to avoid pushing your baby out! And what this does is it closes the sphincters of your vagina, obviously making it harder for your baby to come out. Unfortunately many birth practitioners are still telling you to push during contractions, or surges as we call it, as soon as the baby’s head is visible, but forced pushing can cause your baby to be pushed back up unnecessarily and then it often seems as though the baby is “stuck”, which can lead to a very long second stage of labour, possible interventions and sometimes even more complications. It’s also very hard work for you and the baby, it can tire you both out and again can therefor lead to interventions because you’ll just be too tired to keep this up and get the baby out.
By tensing your whole body during forced pushing your perineum will also be tense, which can be one reason for tearing. If you’re naturally bearing down on the other hand, or in other words, if you have the natural urge to push, do your best to relax as much as possible into this feeling and let your body lead the way. This is completely different to forced pushing or coached pushing as many people call it, as it’s more of a “gentle” nudge than you actively tensing almost every part of your body.
2 - Breathe, Hum or Roar Your Baby Down: Which leads me to tip number 2, which is breathe or hum or roar your baby down. Birth humming is a technique I teach in The Wise Hippo Birthing Programme and this is exactly what you can do instead of pushing. By breathing or humming your baby down you get as relaxed as possible by keeping your jaws relaxed which are connected to your pelvic floor muscles. And the more relaxed you are, the more oxygen goes to your muscles and tissues, which helps them stretch and loosen up even more. As we can’t really practice this before giving birth ;), a way you CAN indeed practice it in a similar way, is when you go for a poo. Yes, I said it... Next time you go to the toilet be patient, give it time, and breathe or hum IT down.
3 - Trust Your Baby: The third tip is to trust your baby. One of the reasons many women start pushing and often end up with tears, is because they just want the baby out as quickly as possible. However, babies don’t usually come out so fast, especially if it’s your first birth. There is a bit of a back and forth going on of the baby pushing its head against your perineum and then going back up a little bit, and that’s a good thing. This allows your tissues to stretch slowly and eventually become flexible enough to birth your baby.
4 - Have Waterbirth: Tip number 4 is to have a water birth, if you can. Water relaxes your mind, your body, and your tissues and that can help prevent tearing big time.
5 - Perineal Massage: My fifth and last tip for today, and this can be triggering for some of you, is to have a perineal massage. Some believe it doesn’t do anything and can even cause infections due to bacteria on your fingers. Others are certain it helped them not to tear. I did practice it, not exactly regularly, but I’m sure it didn’t do any harm and helped me trust my body even more. You can do this daily in the last few weeks before giving birth to increase the suppleness of your muscle tissue, or you can even ask your partner to help you out. 3-5 minutes a day is absolutely fine and it will also help you connect with your body and your baby.