How to Prevent Tearing During Birth: A Midwives Method

Almost every client is worried about tearing during the birth of her baby. Tearing is a real and legitimate fear women have and I am glad that I have the experience to address it! When I read blog posts I want writers to GET TO THE POINT so, I’ll go ahead and bullet out a midwives approach to preventing tears during birth now.

1. Slow down drastically at the birth of your babies head.

2. Support your tissues externally as they stretch during birth.

3. Get body work at term to keep you and your baby in an ideal position for birth.

For those of you who want more information about those bullets above I will go into detail now.

1. Slow down drastically at the birth of your babies head:

The whole purpose of this is to allow the vaginal tissues to stretch instead of popping open. (I know some of you just did a involuntary kegel with that word pop! Lol.) When a client reaches term, we discuss that when she feels a burning or stinging sensation during pushing (otherwise known as ‘the ring of fire’), she should communicate that to me. This is the point where the head is crowning, or where the largest portion of the head is at the vaginal opening. Its interesting to me that slowing down at crowning isn’t something that women naturally do. Its much more common for women to feel the intensity of crowning, think to themselves that they can finish the birth real quick and just blast the baby out. This is the point when your support people come in. When I see and hear that a woman is crowning I say a couple things. First, I ask her to take a breath, then open her eyes and tell her it’s time to slow down. Then we lock eyes and take a couple big breaths together. If she can just breathe through a couple contractions, allowing her uterus to push but not putting force behind it, that is usually all the stretching that the tissues need to be tear free!

2. Support your tissues externally as they stretch during birth:

Otherwise known as perineal support. See image below.

When I’m at a birth as a midwife, I use a folded washcloth to support the anus and perinuem as much a possible during every contraction once there is active head movement with pushing. This extra exterior support not only reminds mom to slow down but also holds the skin together to keep tearing from happening. Perineal Support is even more beneficial if the mom is providing it for herself because she can feel exactly where the support is needed, but alas, it’s difficult for her to reach! Providing perineal support can be discussed with your care provider to see what their practice is.

3. Get body work at term to keep you and your baby in an ideal position for birth:

An ideal baby position at birth will keep the diameter of the head the smallest it can be to lessen the likelihood or tearing. This means your babies chin will be well tucked and the babies back is towards your belly, on the left hand side. Body work can align YOU, so the baby is free to move to the best position. I always recommend a deep tissue massage therapist who is comfortable working on pregnant moms for body work.

Notes to know:

There are degrees of tear depth, that go anywhere from just a scratch all the way to through the anus. See the image below:

Questions? Feel free to contact me or comment below.

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Doctors, nurses, partners, doula… Oh my! Theres a place for everyone?!

It does seem like a lot doesn’t it?! Plus laboring mom that’s five people right there! It feels like too many to be watching you push a head that feels SO big, right out of you. I know, and it might be if everyone stayed there staring at you the whole time. But while your working your baby down and out, theres all of labor to go through beforehand. Though everyone will be there at the very end, I promise, you won’t care!  

Let’s break it down. First of all, you should know that your doctor plans to only be in the room with you for the very last moments of your birth.  Like, once they  can see the head, they will be there with you and stay until the birth of the placenta. And then they are saying, “Congratulations!” and are out the door. Its not that they dont care about you,  its just that they don’t want to be a disruption. So they do their work and wait to be summoned by the nurses.  At the very end, it’s very exciting, you can feel how close you are and the doctor flies in like a burst of light! They catch your beautiful baby and then is gone to let you mask in the glow of the sweetest baby you have ever seen!

The nurses are in and out of the room.  There’s no way to tell who you will get, and shifts change whether you want them to or not.  They are smiling at you while they monitor you and the baby.  They do vitals, listening to the babies heartrate and charting everything.  If you need ice chips or more pillows, they will be happy to grab them for you.  They are so sweet but usually have other moms to help too.

Your partner is your rock.  They arent leaving your side and are supporting you though every contraction. They are encouraging you,  massaging you and sneaking you honey straws. Your partner is a dream until they don’t know what to do anymore.  Here’s where the doula cones in. 

The doula is the gap filler, the runner, the second support to the partner and laboring mom. It can get tribal during labors, it hurts! Mom can get interrupted, loose her flow and start getting anxious or scared,  feeling out of control. The doula is there to help know what to say, what positions to try next. To remind everyone that this is normal, that we can continue to say yes to the process, and that this is the feeling of your baby getting closer to meeting you! She will also do little things like making sure your cup is full, you are emptying your bladder and that your partner doesn’t need anything. 

Laboring mom, partner and doula are the three constants in the room. While nurses and doctors come in and out, the partner and doula are charged with maintaining a calm and supportive atmosphere, your doula especially is a sponge of things that could effect the couple.  Simple questions, comments, opened curtains are no match for her! 

Really, with a role for everyone, it works together really nicely. You can even add a photographer in there or best friend who’s only job is to hold your hand and it would be great.  

Getting Partners involved in Birth

As a doula and midwifery student i see a lot of dads and other partners at a birth who are standing around awkwardly, just lost, and not knowing what to do. And thats okay, i know how hard it is! I started out that way too, but now im deep in this process of supporting women during birth here in the Greater Cincinnati area and have learned some things. I want to prepare you, as partners to a pregnant woman, to be your very best self, one who is prepared, willing to work hard and will meet the mom right where she is.

So there are a couple things I want to talk about…

First: If you get nothing else from this post, I want you to remember that during a birth, you should be calm, grounded, peaceful and know without a shadow of a doubt that she can birth her baby. Everything else after your grounded energy comes second. And for those of you who are list people, here are the top things i think you should have under your belt.

Before the birth, its incredibly valuable if you, as the partner…

  • have met the care provider and established a relationship of trust and respect
  • are friendly, grounded and aware of others in the birth space
  • know the mothers birth plan and a little about each aspect
  • share the mothers expectations of you during the birth experience
  • have practiced different positions and ways to touch her during her labor
  • are familiar with the stages of labor
  • have 2-3 encouraging phrases that you know she will like to hear during her labor
  • know that its inappropriate to be on your phone in her line of vision during the labor
  • are able to establish boundaries around the mom if she needs a it
  • be open to having an experience too

Luckily for you… I have midwifery classes, which means i have to make client handouts, and then want to share them with all of you! So here is mine on supporting moms as partners during her labor and birth : ) PS: its a trifold incase you want to print it out and enjoy. Partners at Birth.pdfbuiltforbirth-1