You’ve probably heard some nightmare stories about perineal tearing during birth. Phrases like “destroyed,” “torn apart,” and “ripped” are not words any of us want to hear in reference to our downstairs area. I myself experienced a second degree tear, which took the midwife nearly 40 minutes to stitch up (yeah, ouch!). But despite what you’ve heard from your girl friends, and even despite my own experience, tearing doesn’t have to be an unavoidable event. You can prevent perineal tearing during birth and I’ve got 3 essential tips for labor to prove it.

It’s true! I’ve seen women give birth with minimal to no tearing with my own eyes. The look of relief on my clients’ faces after being told their vaginas were still fully intact was priceless. Many women worry about what vaginal birth will do to their vaginas. Perineal tearing is often the butt of jokes in the media and we’re usually shown women, and particularly their male partners, freaking out about it. While we all have valid concerns and pelvic health is not talked about nearly enough as it should be, it’s important to remember and normalize that pregnancy and birth changes our bodies. Those changes are natural and physiological. But, that doesn’t mean we can’t work with our bodies to minimize perineal tearing, especially because of the side effects that can come with it afterword.

Perineal health can greatly impact our quality of life. Tearing can weaken our pelvic floor causing lots of issues from incontinence to sexual discomfort or pain. The key to avoiding tearing is three-fold, but the most important factor is preparing your body ahead of time. Ready to find out how? Let’s go.

Understanding Perineal Tearing

The perineum is the small, thin patch of skin between the vagina and anus. This erogenous zone creates a supportive foundation for your pelvic floor, the collection of muscles that holds your reproductive organs, bladder, and colon. The pelvic floor muscles are responsible for helping you give birth vaginally.

During the second stage of labor, the perineum stretches to accommodate your baby’s emerging head. Often times, this stretching causes a tear in the perineum. While often minor, tears range from the 1st to 4th degree (4th being the most severe), possibly causing damage to your pelvic floor and anal sphincter.

Your perineal health goes beyond giving birth. Having a strong, healthy pelvic floor can prevent future issues like urinary and fecal incontinence and pain.

Strengthen Your Pelvic Floor

The majority of us have no idea what the state of our pelvic floor is. I was certainly guilty as charged in this area, too! But after my experience, I went to a pelvic floor therapist for help, and I encourage you to meet with one BEFORE you head into labor. 

Why? Well because the majority of us have no idea what the state of our pelvic floor is. I was certainly guilty as charged in this area, too! But my therapist told me women don’t have to wait until they experience issues after childbirth to seek out help. Visiting a pelvic health specialist while pregnant can help you assess your perineal health and get exercises and tips to get your vagina ready to push out your baby without shredding your taco (can I get an amen!). 

Exercises like kegels, squats, toe taps, happy baby yoga pose, and diaphragmatic breathing are all great for connecting to your perineum and strengthening the pelvic floor.

It is possible that your perineum is already so tight that it’s constantly contracting, like for those who have the condition vaginismus. Learning to release those muscles can be just as important as strengthening them. 

Doing pelvic floor exercises that are right for your body all throughout pregnancy will make a difference in helping to prevent perineal tearing. 

Stretch Your Perineal Muscles

Vaginal tearing happens when the skin and tissue around the vagina can’t stretch enough for your baby’s head during pushing and the pressure then causes tearing (don’t look up pictures, you’ll thank me later for that). To better accommodate your baby and the pushing stage, it’s best to start stretching out your vaginal opening in the last few weeks of pregnancy. 

To do this, you can get into a comfortable position or be in the shower with one leg raised on a supporting surface. Use a lubricant or massage gel (avoid water-soluble) on two fingers and gently massage and stretch the opening of your vagina towards your rectum and out to the sides. Try to do the massage daily for 5 minutes starting from your 34th week of pregnancy until you give birth (unless otherwise noted by your care provider). 

Research shows strong evidence that doing a perineal massage regularly at least 3-4 weeks before labor greatly increases your likelihood of having a vaginal birth without the damage. 

Don’t panic if you miss a day here or there. The important thing is to encourage more elasticity in your perineum. 

If you want to have some fun with it, spice things up and ask your partner to do the massage for you.

Get Your OB/Midwife To Support Your Perineum

While you’re pushing your baby into this world, your doctor or midwife should be placing a warm compress on your perineum and applying gentle pressure to prevent tearing. The warmth helps aid in the vagina’s stretching. Your care provider can do this in whatever position you are choosing to birth in. 

Ask your provider about how they plan to support your health and prevent perineal tearing during labor at your next prenatal visit.

There you have it, mama! Three sure-proof ways to help prevent perineal tearing during birth.

Get more insider tips and the support you deserve during pregnancy by joining one of my Prenatal Support Circles.