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Posted 09 February 2013 - 09:40 AM
I'm just starting to do some research on this topic and I've read about all sorts of wild & wonderful things.
Massaging the perenium, evening primrose oil, squats, epi-no (can't even figure out what that is!)...
Posted 09 February 2013 - 09:43 AM
I'm considering using the epi-no device. You can request a free info pack on their website.
I had a third degree tear last time and it was horrible to heal from.
My plan is to labour in water as this helps with stretching too.
Posted 09 February 2013 - 09:43 AM
Listen to your midwife when they tell you when to push and when not to push
as PP said, water birth is also excellent to help with it.
Edited by R2B2, 09 February 2013 - 09:44 AM.
Posted 09 February 2013 - 09:58 AM
There are things you can do to help minimise the risk such as birth position and having a good birth coach but I am not so sure that too much you do antenatally will help...I did it all and still had a very large tear with my #5.
I think a lot has to do with genetics, size of baby and as I said having a good birth coach.
I never used an epi-no but anecdotally I do not think I have noticed a huge difference for the woman who did use them although I am certain some woman will have found them very positive.
Posted 09 February 2013 - 10:03 AM
I had an epi-no and think it helped with understanding the stretching feeling. However I ended up with forceps and an episiotomy that tore further, so there's no guarantees.
Posted 09 February 2013 - 06:28 PM
I don't know if this had anything to do with it but I spent my whole 1st labour in the shower including the birth had 20 mins pushing and slight tear (not painful at all healing wise). 3rd baby spent most of labour in the shower and retired to bed for birth 15 mins pushing no tear. Like I said though, not sure if that was the reason but worth a try right?
Posted 09 February 2013 - 06:38 PM
My OB held a wet cloth to my perenium when DD1 was crowning. He also got me to push very slowly. I was lying on my side on the bed which meant he could control it better. No tears. I pushed for about 20 minutes.
DD2 was a bit faster(about 10 min) but still no tears.
I might add that I have very few stretch marks after 3 full term babies. Maybe it helps to have more "elastic" skin - perhaps it is partly genetics.
All the best
(edited for clarity)
Edited by ms flib, 09 February 2013 - 06:51 PM.
Posted 09 February 2013 - 06:43 PM
I didn't tear at all
I used the Epi no, though not as often or for as long as I'd have liked and never got anywhere near the max inflation. I also told the midwife I was desperate not to tear and so she used warm wet cloths on the perineum and didn't rush the pushing stage at all (took 2 hours). She did however constantly check DSs heart beat during pushing because it was taking so long, and that was agony.
Posted 09 February 2013 - 06:52 PM
I've not had a baby myself yet (just started TCC) but where I'm from originally (Germany) everyone does the perineal massage.. Midwifes and Obs recommend it to all the pregnant ladies. They also recommend to drink raspberry leaf tea to prepare for the birth, one of the benefits is to loosen and soften the pelvic floor muscles and tissue, increase blood flow to the area etc. You must not drink it before week 37 or even later in order to avoid early contractions etc.
I've just looked at the Epi-No website as I've never heard of it, looks interesting and llike it might be worth giving it a go too! will keep this in mind for when I need it..
I guess you can never have a guarantee that you won't tear, but if you can lower your risk then that's great..
good luck :-)
Posted 09 February 2013 - 06:54 PM
Birthing position, baby size and listening to your care provider about pushing. We did perineal massage with first pregnancy, did jack IMO, other than being incredibly uncomfortable. 1st head circumference was 37cm (2nd deg tear - delivered on my back) and 2nd was 36cm (just a small graze, delivered on my side). I agree that it has more to do with your natural elasticity etc (same reason some women have stretch marks etc)
ETA - oh and pushing for both was about 20mins, both normal presentation etc.
Edited by ~~~, 09 February 2013 - 06:56 PM.
Posted 09 February 2013 - 06:54 PM
I have to agree with listening to your midwives. Although I had somewhat assisted pushing with both labours as I had an epidural both times.
DD was 2nd degree tearing but she shot out very quickly once her head was out. Healed fine though, no pain/discomfort.
DS although his pushing stage was quicker he came out nice and slowly, head first then one shoulder etc and only had slight 1st degree tearing.
Posted 09 February 2013 - 06:58 PM
I dunno about the skin elasticity thing because I am COVERED in stretch marks from DS but pushed his 37cm head out without a tear. My midwife used warm towels on perineum and coached me to push the head out quite slowly- I think this definitely helped.
Posted 10 February 2013 - 10:22 AM
I definitely think listening to your OB/midwife on when to push and when to hold off is the key.
I had an epidural but could still feel pressure etc. My OB was very clear on when to push hard, soft and not to. She also spent a lot of time massaging and stretching the skin. Basically as he crowned she told me to stop pushing and pretty much let him slide out on his own, with a few small pushes from me. I did end up with about 6 stitches (just classed as 2nd degree tear) but have had barely any pain or discomfort from it.
Re the skin elasticity - I don't know. I got barely any from the pregnancy yet my boy had a little 33cm head and I tore...
Posted 10 February 2013 - 10:31 AM
I didn't mean that you won't get stretch marks or tear in the same pregnancy, it was more that some women get stretch marks and some women don't, regardless of preventative creams etc. I don't think perineal massage really works and that it really comes down to position and size of bub's head, rather than how much you tried to "stretch" it before it actually happens.
Posted 10 February 2013 - 10:01 PM
2 babies, no stretch marks or tears.
First one 8lb 11oz, used EPO and RLT up to birth, and spent about 5 hours in shower before delivering on my knees.
Next one 7lb 3oz, really quick labour, RLT but no EPO, no time for the water, delivered on knees.
Do all you can to prevent a tear. My sister had one that was still painful a year later!
Posted 10 February 2013 - 11:14 PM
I used the epi-no and it certainly helped my fear, but I believe it also helped my stretchability!
My ob also spoke very positively of them.
Posted 11 February 2013 - 07:02 AM
Listen to your midwife when they tell you when to push and when not to push
LOL. I was told not to push because I had an internal and it showed I was 9cm. I got off the bed and everything in my whole body said push, but I was told for 45 minutes not to push despite no one really exaiming me again (I even tried in a somewhat vain attempt, to cross my legs). I ended up on the shower floor on my hands and knees and I pushed the head out by myself. The only person with me was DH, I sat up and called out, I think something happened (they were in the room talking to each other) and when they came back in there was a huge panic as they werent ready and had no equipment ready. She came out in the next push, in the shower, with it still on, while I was on my hands and knees.
P.s I am not saying dont listen Just my funny story
Edited by dreamingofcats, 11 February 2013 - 07:08 AM.
Posted 11 February 2013 - 07:15 AM
I think birth position and the position of the baby are really crucial. You can't neccessarily do much about how the baby is positioned (though the spinning babies website is good on that factor) but not lying flat on your back to deliver is one way to help. I am only talking anecdotally and based on what I've read, but I think being flat on your back isn't ideal as the baby has to push out at a strange angle and without the help of gravity. All fours, standing up, squatting - all of those are more effective.
Of course I may be slightly bitter as I pushed out a 4.2nd VBAC baby flat on my back and got a 4th degree tear to show for it! But it healed quickly and I have had no complications from it since if that helps to allay your fears OP.
Posted 11 February 2013 - 07:28 AM
Speak to your midwife and tell her you want her to assist you as much as possible to avoid tearing. I had tearing with my first labour, and was determined the second time to avoid it. Spoke to the midwife as soon as we arrived at the hospital, and she coached me throughout the labour...when to push, when not to push etc. Came out the second time without a graze!!
Edited by dirtgirl, 11 February 2013 - 07:28 AM.
Posted 11 February 2013 - 07:34 AM
I tell my pregnant friends to do perineal massage. I did it from probably 34 weeks or so, just about every night, and could feel the improvement in stretchiness over that time.
Also used epo but that was to try and bring on labour (I was induced as she was late).
I delivered on my side (I think, its a bit hazy thanks to the gas), 39cm head,oe tiny graze that I only felt for 24hrs.
Posted 11 February 2013 - 08:34 AM
Thanks everyone, I am really enjoying this discussion & ideas, keep them coming!
Posted 11 February 2013 - 08:38 AM
I used the epi-no with DS, but probably not as much as I should have, and ended up with a 1st degree tear after delivering a 2.825 kilo baby
That was after delivering on my side as well.
I'll be doing more this time to try and avoid tearing!
Posted 11 February 2013 - 09:14 AM
I was going to post about the same thing.
At my midwife clinic last week the midwife was recommended that we start thinking about perineum massage from 35 weeks. Most of us were horrified. She also recommended the epi-no. She told us that they notice a big difference in women who do the perineum massaging or using the epi-no vs those who don't.
I asked my friends. None of them used it or did the massaging. One of them had an epi done. Mum did too but she had no complications or worries from healing from it.
I have no idea! I'm curious about checking out the epi-no though...
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