I have recently been asked a few AWESOME questions in preparation for birthing at home. These questions are normally always asked, unassisted or not! I will be posting a series of Q & A’s. Here is the first one:
What if I rip/tear?
First of all I think it is great if you have these concerns. The best way, in my opinion, is to consider the unpleasant or scary things and figure out an action plan just in case.
[And remember, unpleasant and scary things happen everywhere. So let’s also keep that in mind so we aren’t subconsciously connecting hospitals with safety. Home birth is safe!]
Ripping or tearing is a concern for most. How in the heck is an entire baby going to make its way through there?! Well let me tell you, I’ve seen large, 10# babies exit their mothers with zero issues!
Tearing is a natural occurrence, but doesn’t always need to happen! our bodies are designed for birth- including a strong, stretchy perineum. Not only that, our babys skull bones are not fused together just yet, allowing their head to cone for an easier departure through the pelvis and birth canal.
Most of the time, when you hear stories about someone tearing at their birth, they were pushing on their back (against gravity), and pushing against their bodies natural rhythm (coached pushing). Pushing in a more upright position, breathing and letting your body stretch slowly, allowing FER (fetal ejection reflex) to take over is the best way to prevent tearing! Birthing in water helps a lot, too!
After that “ring of fire”, when the babys widest part of its head is starting to appear, it is easy to begin to panic a bit. With my first vaginal birth I totally panicked from the searing burn it causes, and I wanted that part to end ASAP. So I pushed as hard as I could to make it end. Pushing so hard and so fast led to an undesirable outcome. I tore, almost ripping my labia right off, and my daughter had a hell of shock coming out that fast. So with that experience I learned how important it is to have someone there with you to remind you to take it slow. It may feel AWFUL at that moment, but it will soon be over. All of the pain from that and your labor, will completely disappear within the first sigh of relief that its all over. Poof. Gone. #worthit
Want to see a perineum in action? badassmotherbirther on facebook
So what happens if you do?
Simple! In most cases, you do nothing. Most minor tears or abrasions will heal on its own.
There are some things you can do to help speed up the healing process:
-Manuka Honey.
-Seaweed (Nori) Sheets.
-A piece of the amniotic sac.
But most of all, rest is required. Herbal sitz baths may help too!
It is super unlikely that you will tear deeply. But if you do, you can request to be seen by a provider within the first few days. If you continue to have a provider through the end of your pregnancy, you can call to see where they recommend you to go. It may be in their office, or at the hospital. If you go to the hospital, I do not recommend bringing the baby with you, unless you have concerns for the baby too. (Hospitals often treat home birthed babies as “dirty” and will want to poke and prod, searching for any problem they can find/create.) Otherwise, you can call an urgent care or Labor & Delivery, or another home birth midwife to see if they can offer advice or assistance.
Manuka honey is very expensive! But you may be able to find a small packet at a drugstore or online. You wont need much if you decide to try it.
In conclusion: The best way to treat a tear is to prevent it from happening in the first place! Perineum “massages” (in my opinion) do nothing but weaken and break the tissue down. So please do not stress out about that! I know it is still recommended in all the mainstream books but the evidence is lacking that it helps at all.
This article explains: https://www.lamaze.org/…/what-is-the-evidence-for…
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