Question about tearing

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Question about tearing

Postby elvixen » Sat Aug 02, 2014 5:07 pm

So probably the thing i am most concerned about for this birth is tearing. I had a natural unmedicated birth with DS and a small tear and a few stitches. Although there wasnt too much pain from the tear at the time and it healed just fine, I still get some occasional pain in the same area with sex which i am assuming must be from that.

My question is, are you more likely to tear with subsequent births if you did with the first one? Does that make an episiotomy more necessary/beneficial? I will be asking my midwife about this too. I am just imagining that it would be extremely painful to tear open again in the same place.
Me: Elena, 26.
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DD: 1 (born 11 Nov 2014)
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Re: Question about tearing

Postby JanuaryMama » Sun Aug 10, 2014 6:25 pm

Nope not always! I have a few friends who had tears with their first but none with their second. One friend of mine had a midwife that helped to stretch things out while she was pushing to help stretch the skin. She said she and no tearing and bounced back so much faster after birth as a result. If that is something you are comfortable having done ask your midwife about it!
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Re: Question about tearing

Postby B Michaelson » Sun Aug 31, 2014 6:57 am

The thought of both tearing or episiotomy freak me out. I read about perineal massage and am hoping there is some merit to it. I will do it anyways I am sure since it can't hurt.
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Re: Question about tearing

Postby shellsbellsxx » Sun Aug 31, 2014 7:38 am

I think the episiotomy is the lesser of two evils as if they think you are going to tear they will inject anaesthetic into the area before they cut (my sister never even noticed she had been injected nor had been cut until afterwards)! I was present in both scenarios at both my nephews births and definitely the episiotomy in her case was better, neater and easily stitched. Her second was emergency extraction with suction cup and a lot of pulling, tearing was the least of their worries.
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Re: Question about tearing

Postby B Michaelson » Sun Aug 31, 2014 9:59 am

I agree Shells. It's recovery after that gives me shivers lol. But I would rather be cut than tear.

I will feel lucky enough to avoid a csec if possible though, so really I would take either over that.
Me - 36
Hashimotos, JHS/EDS, ANA negative, 1 Fallopian tube
DH - 41
TTC #1 Aug 2012 - May 2014
DS - Born Jan 2015
TTC #2 since Aug 2016
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Re: Question about tearing

Postby elvixen » Wed Sep 17, 2014 4:49 pm

Thanks for the responses, ladies. I talked to my midwife about this at my last appointment. She actually said she recommends avoiding episiotomies wherever possible and that in her experience tears (as a more "natural event") heal a lot easier and with less pain. Anecdotal evidence would suggest this isn't always the case, but i can see where she's coming from. Like a few people have pointed out during childbirth we are so focused on the job that often you don't even realise you've torn and it's not really a big deal. She also talked about "breathing the baby out" in the final stages which can help a lot with preventing tearing. I'm feeling more relaxed about it all anyways and i'm def not going to request an episiotomy unless she deems it necessary at the time!
Me: Elena, 26.
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DD: 1 (born 11 Nov 2014)
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Re: Question about tearing

Postby B Michaelson » Wed Sep 17, 2014 5:08 pm

I am hoping tearing is not genetic like stretch marks. I guess my mom tore all to heck with me and I was only 5lbs 3 oz. She said her csection recoveries were almost easier :S
Me - 36
Hashimotos, JHS/EDS, ANA negative, 1 Fallopian tube
DH - 41
TTC #1 Aug 2012 - May 2014
DS - Born Jan 2015
TTC #2 since Aug 2016
May 2017 :bfp:

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2004 - 7.5 weeks
Oct 2013 - 6w6d ruptured ectopic
Jan 2014 - Chemical

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Re: Question about tearing

Postby tinybud » Sun Oct 12, 2014 9:06 am

Having had 2 severe tears, and one episiotomy, let me tell you that the episiotomy was definitely the most painful to recover from. My theory is to see what happens - if you get the epi you will definitely have stitches. If you don't you have at least a chance of no stitches.
The only way I would get an epi would be in an emergency delivery situation.
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Re: Question about tearing

Postby Robbie88 » Wed Oct 15, 2014 3:11 pm

Thought I would pipe in here, with my son I felt myself tear (i had a unmedicated vaginal birth) and my description is it was like paper tearing and it truly wasn't that bad in comparison with everything else that was happening. I recovered really quickly and had 5 stitches. My doctor helped to stretch me so that it wouldn't be too extreme, alot of the time apparently it is way worse if the baby comes really quickly so your body doesn't have the time to adjust.

A friend of mine had an episiotomy and she had such a worse recovery from me and 6 weeks later was still dealing with discomfort from her stitches.
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Re: Question about tearing

Postby momma34 » Fri Oct 24, 2014 10:08 am

In the US we don't do episiotomies anymore for the purpose of avoiding tearing. They are only done if the opening is not big enough for baby to come out. Episiotomies can actually lead to higher grade tears (once you start the cut it keeps spreading) and can lead to worse outcomes like tears all the way to the rectum and higher incidence of incontinence later. My mom had episiotomy with her first and then had a horrendous tear that went all the way through - she said that was really painful to recover from. I am not an OB - but definitely did OB rotations as a med student, and while tearing is scary, it typically is more related to how fast the baby comes down, slower labors mean less likely to tear. Also smaller babies are less likely to cause tears. But perineal massage/oils are definitely helpful, and making sure the perineum is supported by the person doing the delivery. I think kegels can also be helpful in the overall delivery process. Anyways, if you don't need an episiotomy to help the baby come out, I personally would avoid it!!!
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Re: Question about tearing

Postby specialkel » Wed Oct 29, 2014 12:10 pm

I asked my midwife the same question, as I had small tears with both of my daughters after their unmedicated deliveries. She said there is no correlation and that the biggest factor is how quickly the head emerges (how much time the perineum has to stretch naturally). That's why you're supposed to stop pushing at least briefly when the head is crowning. At my hospital the nurse massages the perineum with some type of oil at that time as well to avoid tearing.

My midwife didn't say this, but it makes sense to me that the baby's position makes a difference, too. Like if baby is posterior or has a hand by its face, for example. I also have a feeling that the position you deliver in makes a difference. I was pressured a little bit to be semi-sitting while pushing even though it felt completely unnatural and went against my intuition (I had been laboring either standing or on my hands and knees). If you're pushing in a position where your pelvic outlet is bigger, I would think that chances of tearing are smaller. Hopefully I'll have a chance to test this theory in a couple weeks! :wink:
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Re: Question about tearing

Postby shadypersephone » Wed Oct 29, 2014 12:35 pm

Just wanted to contribute what I've learned so far. Like others have said, a tear is easier to heal from than an episiotomy is. It's because you tear between your cells instead of just straight through them like you would with an episiotomy (which does lead to more tearing if you get one). Also, just read that massage is critical in the weeks leading up to the birth but during birth what's more important is support. Just gauze held over the area helps. It's advised not to let them massage you during birth as it can increase blood in that area, which can lead to slight swelling, which can cause a tear. And birth position can matter as much as baby's position. So, if you birth in a squatting position, even though it opens the crap out of your pelvis, it speeds up labor to such a degree that it can lead to tearing. Same with hands and knees birthing.
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Re: Question about tearing

Postby B Michaelson » Thu Oct 30, 2014 6:36 am

All good info, thx ladies!
Me - 36
Hashimotos, JHS/EDS, ANA negative, 1 Fallopian tube
DH - 41
TTC #1 Aug 2012 - May 2014
DS - Born Jan 2015
TTC #2 since Aug 2016
May 2017 :bfp:

:angel: Our Angels :angel:
2004 - 7.5 weeks
Oct 2013 - 6w6d ruptured ectopic
Jan 2014 - Chemical

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