10 ways to avoid tearing when pushing
Tears in the vagina are THE # 1 fear of most expectant mothers. Fortunately, there are several ways to avoid them.
1. Consult a perineal physiotherapist.
She can teach you specific and progressive techniques from the 34th week to allow your perineum to have optimal flexibility on the day of delivery. She can also offer you valuable advice on taking care of your pelvic floor after childbirth.
2. Stretch your perineum.
From the 36th week of pregnancy, stretch your perineum muscle daily. It will be more flexible at the time of the push, and above all, you will have less tendency to tense up when the time comes, because your brain will recognize the sensation. To find out how, ask your perineal physiotherapist, or do a little research on the web!
3. Help your baby to come down.
If you can, do not lie down during the push. Adopt positions that promote gravity: standing, sitting, squatting, on all fours, on your knees… Use the suspension bar that is installed on the bed to support you if necessary.
And if the pressure felt in your buttocks is too strong, get on all fours and lie down with your head on the bed, keeping your buttocks up. The further down your baby is, the less likely it is to force it to come out.
4. Avoid epidurals.
Studies have shown that epidural analgesia increases the risk of procedures, including the use of suction cups and forceps. Since these instruments make the baby's exit a lot faster, they often cause tears because the tissues do not have time to stretch enough.
Also, to be able to use these instruments, the mother must be lying on her back, which reduces the space in the lower pelvis and requires even more force to take the baby out.
5. Wait for the right time to push.
Once your cervix is fully dilated, you don't need to push right away. If your baby is okay, let him continue his descent at his own pace. This will prevent you from pushing for hours, and your pelvic floor will thank you for it.
In addition, if you are not on epidural analgesia and let the baby get low enough, you may be lucky enough to experience an ejection reflex. Your body will then push your baby with power, without you needing to add more. Yes yes, it does exist! And believe me, it works!
6. Don't block your breath.
Although this is always what we see in the movies, it is not the best way to push your baby. If you fill your lungs and block your breath during the push, you will add tremendous pressure to your pelvic floor muscles. It will be faster, but very difficult on your body. So if there is no medical emergency, there is no reason to do this.
When the contraction arrives, instead try to exhale hard while pursing your lips, as if you want to extinguish a candle in the distance by blowing into a straw. This will activate your deep abdominals and accompany your baby more gently. If you can't figure out what I'm talking about, subscribe to our prenatal classes! We will give you a demonstration live!
To relieve even more pressure on the pelvic floor, it is recommended that you stretch during the contraction to keep the organs up and reduce the pressure on the pelvic floor. For example, you can pull or push on something while pushing.
8. Apply warm compresses.
During the push, ask the nurse or your partner to apply a warm compress to your vulva. This will relax your tissues and allow better elasticity.
9. Blow on the sensation.
When your baby's head reaches the vulva, you may feel a burning sensation. We call it the “ring of fire”. At this point, it might be tempting to push really hard to get baby out and have that feeling behind you. But if you can, stay there.
This slow outward passage was designed to allow the fabrics to stretch and prevent tearing. Take short, panting breaths, to help you live this moment. Visualize your tissues relaxing. Then, in a few minutes, that sensation will be just a vague memory and your baby will be in your arms.
10. Have a doula accompany you.
Continued support from a birth attendant has been shown to help reduce interventions that can complicate the relapse and increase the risk of major tears. Inquire about our birth support service!
Birth attendant, perinatal naturopath and massage therapist
Member of the Les Premiers Moments team since 2018