Fourth degree tear

iVillage Member
Registered: 01-09-2011
Fourth degree tear
5
Mon, 09-03-2012 - 11:32pm
I had a fourth degree tear that had to be repaired three times in the first few months of my daughter's life two years ago. I just found out I am pregnant again, after ttc for a while so I am very excited but also concerned. With my first birth I was not as well prepared as I might have been, my birth class at the hospital didn't offer any coping techniques and I was bullied into what I think was an unnecessary induction at 41weeks. I had a pretty detailed birth plan and wanted to wait and see how it was before deciding on an epi or not but they wouldn't let me move because the monitors kept losing the baby so I couldn't deal with the pain and got an epidural, which failed. I was partially numb, mostly on my right side but my left leg felt like it weighed a thousand pounds. I could still feel contractions and I knew I was tearing badly because I could feel it and see the horrified look on the dr and nurses faces while my mom passed out and my wife turned white as a sheet. I knew it was bad. I pushed for more than three hours practically flat on my back and the nurses kept wandering away and said "we" were going to take a break for a few contractions so I could preserve my strength, which of course I could NOT do, the urge to push was too strong to just stop and hang out for 15 minutes or so. My daughter finally came out, 8 lbs 5 oz so not a huge baby but a little bigger than average. This time around I am planning an all natural birth with a midwife and a doula but my wife is terrified and thinks I should just sign up for a csection right now because I am insane to go through that again. I think it would have been a much smaller tear if I had done it naturally and had proper support and better positioning. Is there anything I can safely do during my pregnancy to prepare my perineum for this next birth?has anyone here had a similar experience? I don't have an appointment with my new midwife for another month or so but my mind is spinning with all of this - what advice do any of you have for a situation like this? I would really appreciate any info. Thanks in advance!
Community Leader
Registered: 04-18-2003
Thu, 09-06-2012 - 11:40pm

Just to ensure I give the right sort of suggestions, you made mention of "your wife" a few times. Is this a husband/wife posting in tandem or a wife/wife? The only reason why I'm asking is there are some things a same sex partner can do for her labouring spouse that a husband might not feel comfortable doing or is unable to do. I got some awesome suggestions from a wife/wife couple for how to have a good birthing experience.

Gail

iVillage Member
Registered: 01-09-2011
Sat, 09-08-2012 - 10:38pm
Thank you! Yes, I guess I should have clarified that, sorry, I am a lesbian. I would love any suggestions though, heteronormative or not :smileyhappy:
Community Leader
Registered: 04-18-2003
Sat, 09-08-2012 - 11:44pm

As the non-pregnant woman put it "As a woman I know EXACTLY how to massage that area to help prevent major tearing.  There's nothing sexual about what I do to my wife while she's in labour, it's just one woman helping another woman have an empowering birthing experience."

Gail

iVillage Member
Registered: 01-17-2008
Mon, 12-17-2012 - 5:26pm

In our baby classes we were told about perineal massage (see following article):

Perineal massage does not "lengthen" the tissues of the perineum. However, it does increase the stretch in two ways.

First, perineal massage is done with a cold pressed oil, which lubricates the tissue making it softer, more supple and improving is flexibility. This makes it easier for the tissues to stretch as the baby is born.

Second, perineal massage familiarizes the mother with the stretching sensations she will feel as the baby is born. This helps her learn to keep her perineal area relaxed during the stretching of crowning. Keeping the perineal area relaxed may help prevent tears.

How to do it:

Perineal massage can be done by the mother or her partner. The mother should be in a comfortable place, sitting or reclining in a way that gives access to the skin around the vagina. It can be done for up to 10 minutes a day during the last four weeks of pregnancy.

  • Wash hands thoroughly. Ensure there are no sharp or long nails that may scratch the mother.
  • Locate the perineum, directly below the vagina. It is the skin between the vagina and the anus. Apply some cold pressed and pure oil (such as olive oil) to this skin.
  • Place the thumbs at the base of the vagina, allowing them the slide inside the vagina (to about the first joint) moving some oil with them.
  • Using gentle but firm pressure, move the thumbs from the base of the vagina up the side walls as if you were making a "U".
  • Return the thumbs to the base of the vagina, and repeat procedure.

As the mother becomes more comfortable with the stretch, you may increase the amount you stretch the skin.

Integrating it into labor:

The mother may perform perineal massage as part of her daily pregnancy bathing routine, before her bath or shower.

The mother and partner may enjoy the stimulation of perineal massage before intercourse.

The mother may perform perineal massage as part of a nightly relaxation routine before going to bed.

We were also told that keigel exercises help. I wish I'd have taken the advice - I had a 3rd degree tear with my son! Good luck!

Tracie, proud 1st time Mommy to Jake! "Every saint has a past and every sinner has a future" - Oscar Wilde