How to Reduce Vaginal Tearing During Birth
Having a baby is HARD, but our bodies are incredibly resilient when it comes to the rapid change pregnancy can bring. Unfortunately, sometimes we still end up with vaginal tears following birth.
Here is the info you need to know to give your body some extra love before baby arrives.
Why do vaginal tears happen?
During delivery, the perineum - the collection of pelvic muscles and tissues between your vagina and anus - has to stretch up to 300% of its typical length to accommodate your baby’s head. If the stretch is too much or happens too fast a tear can occur.
Vaginal tears are common and are graded on a 1-4 scale with grade 1 being a small tear that typically heals on its own and grade 4 requiring surgical reconstruction. In our business, we aim to keep tears grade 2 or less and often can prevent them altogether.
How do I help prevent vaginal tearing?
It all starts with good perineal prep. The perineum is like the north star of the pelvic floor. It’s where many of the pelvic floor muscles meet up and it works as a unit to contract (kegel) or relax.
One of the myths we debunk constantly at Revive Rehab is using a kegel for every problem around the pelvic floor. In this case, it’s all about RELAXING. The pelvic floor and cervix are besties and we need them both to relax together during birth to be able to gain progress with your baby’s position throughout labor. Relaxation can take time and using more gradual pushing techniques during delivery can improve tissue response.
The 3 areas of focus:
Skin and muscle mobility: Early mobility of your perineal skin and underlying muscles can make it much easier for your body to adapt. Check out our guide to perineal stretching here. We recommend an easy 5 minutes 2-3 times per week to stretch the area.
Muscle relaxation: Deep breathing can help mobilize and relax your pelvic floor. Belly breathing with a focus on dropping the pelvic floor during the inhale is a great way to give those pelvic muscles a chance to practice relaxing. We recommend doing this on the toilet. It's a great place to take some time to practice “dropping” your pelvic floor while in a sitting position.
Hip mobility: Last but not least we need to get those hips ready to move! Some easy mobility drills can make a big difference on delivery day. Positions like happy baby, puppy pose, or a deep squat hold are often still comfortable to do late in pregnancy.
What if I still tear?
Panic! No, don’t panic. Tearing is still common and often heals without hospital intervention.
Higher grade tears will be stitched back together, but don’t let that be the end of your journey. Physical therapy is important to improve the strength and mobility of your pelvic floor and prevent scar adhesions from causing future problems. We often see low back pain, pain with sex, pain with pooping, and many other issues as a result of scar tissue and immobility.
Along with pelvic health physical therapy, topical estrogen can be helpful during recovery and should be discussed with your OB/GYN or midwife.
It can also be helpful to use a lidocaine lube - our favorite is Good Clean Love that you can find here or come grab our free samples in the clinic.
Let’s talk about it!
If you are pregnant, newly postpartum, or feel like you never got back to your full potential after delivery, we would love to help.
Our 1:1 personalized care means that we have the time to listen to your entire story and help make a treatment plan that best fits your lifestyle and goals. Let Revive Rehab in Columbia, MO, be your space to ask questions, talk with experts, and get back feeling great in your body.
Book here with a Revive Rehab PT.
We also host an awesome Labor Prep Class once a quarter. Check out the details here!
Movement is medicine! -Dr. Sarah, PT, DPT
