One of the most common questions I hear from expectant parents is: "How do I prevent tearing during birth?" Before we dive into the details, please know that your body is designed to stretch, adapt, and heal.
Different types of tearing can occur during childbirth. The most common is perineal tearing, which occurs between the vaginal opening and the anus. While many people experience some degree of tearing during a vaginal birth, most tears are minor and heal well. There is no guaranteed way to prevent tearing completely, but there are several factors that may help reduce the likelihood or severity of tearing.
Let's explore some of them.
1.Movement During Labour
Labour is not something that happens to you. It is something your body actively does. When a birthing person is free to move, sway, squat, lean, lunge, rock, or change positions, they often find movements that feel instinctively right. These intuitive movements can help create space within the pelvis and support a baby's journey through the birth canal.
Movement is not only valuable during labour itself. Most of us have jobs and lifestyles that restrict our daily movement, leading to tension in the body and making certain movements less accessible when they may be most helpful during labour. Preparing your body during pregnancy through breathing, movement, and body balancing can help your body become more adaptable during birth.
2. Following the Urge to Push
Many people are familiar with the idea that pushing begins once they reach 10 centimetres dilation. In reality, being fully dilated does not always mean the baby is ready to be born immediately. Sometimes the baby is still relatively high in the pelvis and needs time to descend further. There are stories of people waiting hours after reaching 10 centimetres before they were ready for the second stage of labour. Beginning forceful pushing too early can mean spending a longer time pushing and may place additional strain on the tissues. When circumstances allow, waiting for the body's natural undeniable urge to push, tuning into your breathing and allowing the baby's head to emerge slowly can help the tissues stretch more gently.
3. Perineal Massage During Pregnancy and Labour
Perineal massage is often recommended during pregnancy, but opinions vary regarding its effectiveness. In my experience, one of the biggest benefits of perineal massage is helping parents become familiar with the sensations of pressure and stretching around the perineum. This can reduce fear and increase confidence heading into birth.
Some care providers also perform perineal massage during the pushing stage of labour. Current research does not provide conclusive evidence that routine perineal massage during birth prevents tearing. Care providers may also use a warm compress on the perineum, and/or support the baby's head with their hands to encourage a slower and more gradual birth of the head.
As with any procedure during labour, informed consent matters. Understanding your options beforehand can help you make decisions that feel right for you. You can also include your preferences in your birth plan and discuss them with your care provider before your baby's birth.
4. Rapid Labour
Sometimes labour progresses very quickly. While many people hope for a shorter labour, rapid births can occasionally mean that the tissues have less time to gradually stretch. If labour is moving very quickly, changing positions may help manage pressure and encourage a more gradual birth. In my experience, a "head down, hips up" resting puppy pose can help reduce the pressure of the baby's head on the cervix. The following contractions may feel milder, giving you a chance to rest and allowing labour to slow down slightly.
5. Birth Position Matters
Many of us grew up seeing birth portrayed on television with the birthing person lying on their back, knees pulled towards their chest. While this position may be appropriate in some situations, it is not always the most supportive position for birth physiology. Different birth positions affect the space inside the pelvis, the forces of gravity, and the amount of pressure placed on the pelvic floor and perineal tissues. Side-lying, hands-and-knees, and a supported hinge squat better support your body's mechanics and may reduce pressure and strain on the perineal tissues. The best position is often the one that allows you to feel safe, comfortable, and able to work with your body's natural instincts.
6. Water Birth and Relaxation
One of the reasons many people enjoy labouring or birthing in water is the sense of relaxation it can create. Warm water can help reduce tension, encourage relaxation, and support nervous system regulation. A relaxed body often leads to a more relaxed pelvic floor. When the pelvic floor can soften and respond to labour, the second stage can be less strained.
When we talk about tearing, it is easy to focus on a single technique or intervention. In reality, birth is influenced by many factors. Breathing, movement, positioning, nervous system regulation, and individual anatomy all play a role. It is also important to let labour unfold without rushing, and not feeling rushed by others where circumstances allow. Rather than searching for one magic solution, I encourage parents to focus on preparing their bodies, understanding their options, and building confidence in the birth process.
Want to dive deeper into movement, positioning, breathwork, nervous system regulation, birth partner support, and practical tools to help you prepare for birth with confidence? Head to the Classes & Support section to learn more about how I can support you during this special journey.