When I became pregnant, one of my concerns was avoiding a C-section. (I knew you couldn't predict everything that happened in the delivery room and knew that if our life depended on it, I’d have no problem getting one.) But while I was hoping for a problem-free delivery, the last thing on my mind was vaginal tearing and an episiotomy. As it turned out, I had one of each.
Vaginal tears are pretty common during the delivery process. It happens when the vagina opening isn’t big enough for the baby’s head to come through. These types of tears may take a few weeks to heal, and extensive tears could take longer to heal and could lead to infection.
When I delivered my daughter in 2010, I suffered a vaginal tear that felt like the size of Texas. Even though I had an epidural, I still felt stinging around my lady part. I remember the doctor saying that I needed about five stitches to seal the tear.
When I gave birth to my son three years later, I was happy to learn that I dodged the vaginal tearing bullet. However, the caveat was that I wound up having to get an episiotomy to prevent tearing.
My daughter was only 6 pounds and 14 ounces. My son, on the other hand, was a whopping 8 pounds. Needless to say, there was no way his head would make it through my vagina. Even though the episiotomy provided a wider opening for him, I still felt as if my muscles were completely shattered.
The pain that I endured after having my son was multiplied times 10 than what I experienced with the birth of my daughter. While I was able to move around with ease within a couple of days after giving birth the first time, it seemed like healing took an eternity following the birth of my son.
According to many medical experts, current evidence doesn't support maternal benefits traditionally ascribed to routine episiotomy. In fact, research has confirmed that “episiotomy is harmful whether you prepare to avoid tearing or not ... It's almost always worse than a natural tear.”
So if you’re pregnant and looking for ways to avoid vaginal tearing and episiotomy, here are a few helpful tips:
1. Consider delivering at home or at a birthing center
Delivering at home or at a birthing center allows for more flexibility, and being in a more relaxing environment has a lot to do with how you deliver. When I delivered my babies in the hospital, not only was I hooked up to all kinds of machines, I also wasn't able to choose a comfortable birthing position. When I asked my doctor if I could change from the standard birth position, he said no due to hospital policy.
In fact, your position has a lot to do with vaginal tearing. For instance, lying down in the standard hospital birthing position (lying down with elevated legs) puts pressure on your tailbone and perineum, which can lead to tearing.
Experts say that the best position to be in is one where you are most comfortable. Some of the best positions include being on all fours with hands on knees, kneeling or lying on your side. Most birthing centers and at home births also offer the option of laboring in water, which softens the perineal tissues and relieve pressure during the crowning stage.
2. Maintain healthy nutrition
Following a healthy diet throughout your pregnancy can also prevent tearing. Doctors recommend staying hydrated and eating lots of protein protein, vitamin E, fatty acids and flavonoids found in fruits like oranges and blueberries. This will promote tissue health and elasticity, allowing for an easier delivery.
3. Massage the perineum
According to medical experts, you can begin massaging your perineum with edible oils (like vitamin E oil or olive oil) or lubricants like K-Y Jelly in preparation for childbirth at 34 weeks of pregnancy. While it’s unclear how many times you should do it, I've heard that women who massaged their perineum the most had the best outcomes. However, another study revealed that a perineal massage of “1.5 times per week (on average) provided a statistically significant reduction in the incidence of episiotomy, unlike the women who massaged more frequently.”
Whatever you decide, it’s important to do what makes you happy. But most importantly, do your research. In retrospect, I wish I would have done more to prepare for delivery. The idea of being at home or at a birthing center sounds relaxing; I like being able to push while in a position I feel most comfortable. But at the same time, I like being at a hospital in case of a medical emergency. If my husband and I do decide to have another baby, I’d also definitely be more conscious of my diet and give perineal massage a try. I'd do just about anything to save myself the pain and cut my recovery time big time!