By Vanessa Jupe, CEO of Leva

Everyone talks about the beauty of childbirth. It is a remarkable experience - the magic of our bodies and how they effortlessly adjust to grow and support life. However, childbirth can undoubtedly come with physical challenges, including perineal tearing or ripping—the tearing of the area between the vaginal opening and anus—during delivery. While vaginal tearing is common, affecting up to 90% of first-time vaginal deliveries, there are strategies you can use to reduce its likelihood and severity. Let’s explore proven methods supported by recent medical research and real-life experiences from moms.

Understanding Perineal Tearing

FAQs About Tearing and Ripping During Childbirth

Q: How can I reduce the risk of tearing during childbirth?
A: Perineal massage, warm compresses, controlled pushing, pelvic floor exercises, and proper nutrition can all help minimize tearing.

Q: Does perineal massage really work?
A: Yes! Studies show it can significantly reduce the risk of severe tears and episiotomies, especially for first-time moms.

Q: What are the best birthing positions to prevent tearing?
A: Upright positions, such as squatting, kneeling, or being on all fours, are often recommended to reduce perineal strain.

Q: Is tearing or ripping common during childbirth?
A: Yes, tearing occurs in up to 90% of first-time vaginal deliveries, but most tears are mild and heal quickly.

Q: What happens if I tear?
A: Your healthcare provider will repair the tear, and with proper care, you should recover well. Follow recommendations like sitz baths, pain management, and keeping the area clean.

1. Perineal tearing can range from mild (first-degree) to severe (fourth-degree). Mild tears may involve only the vaginal lining, while severe ones can extend to deeper tissues and muscles, including those around the anus.

   Factors that may increase the risk of tearing include:

   • First-time vaginal delivery.

   • Baby’s size (larger babies can put more pressure on the perineum).

   • Assisted deliveries using forceps or a vacuum.

   • A very rapid delivery.

   • Previous severe tears.

   Understanding these factors can empower you to make informed decisions and prepare your body for childbirth. Working with a doula on your birth plan and during delivery is an effective way to reduce your chances of tearing.

Tips to Reduce the Risk of Tearing

1. Perineal Massage: A Proven Way to Prevent Tearing During Childbirth

A 2020 meta-analysis involving over 3,000 participants proved that regular perineal massage from the 34th week of pregnancy onward significantly reduced the risk of severe perineal trauma and postpartum complications. Women who practiced perineal massage experienced better wound healing, less perineal pain, and shorter durations of the second stage of labor.

How to do it:

• Wash your hands thoroughly and find a comfortable position.

• Use a natural oil like vitamin E or coconut oil.

• Insert your thumbs about 1-1.5 inches into your vaginal opening and gently stretch the tissue outward and downward in a U-shaped motion for 5-10 minutes daily.

Mothers who have tried perineal massage often attest to its benefits. One mother, Sarah, shared:
"I was skeptical at first, but after doing the massage daily for my last six weeks, I noticed a huge difference during my second delivery compared to my first. It felt like my body was better prepared to stretch."

2. Warm Compresses: How They Reduce Tearing in Childbirth

Applying warm compresses to the perineum during labor can increase blood flow, relax the tissues, and significantly reduce the likelihood of severe tearing. Warm compresses also provide postpartum perineal pain relief.

Discuss incorporating warm compresses with your birth team. Some hospitals and birthing centers routinely provide this, but you can also bring your own soft, clean cloths if you’re delivering at home or in a birthing center.

3. Controlled Pushing Tips to Minimize Perineal Trauma

The way you push during delivery plays a significant role in preventing tearing. Research suggests that a slow, controlled delivery of the baby’s head allows the perineal tissues to stretch gradually, reducing the risk of severe tearing.

To achieve controlled pushing:

• Listen to your healthcare provider or midwife's guidance during crowning.

• Focus on short, gentle pushes rather than long, forceful ones.

• Use breathing techniques to stay calm and avoid straining.

4. Pelvic Floor Therapy: Strengthening Muscles to Prevent Tearing

A 2024 survey highlights the importance of pelvic floor health in preventing complications such as tearing and aiding postpartum recovery. Strong pelvic floor muscles improve elasticity and control during labor.

How to do Kegels:

• Identify the muscles used to stop urination.

• Tighten those muscles for a count of five, then relax for five.

• Repeat 10-15 times, three times a day.

The survey revealed that pelvic floor dysfunction (PFD) affects one in three postpartum women, yet 96% of cases go undiagnosed. Incorporating pelvic floor exercises before delivery may reduce the risk of tearing and improve recovery outcomes.

5. Hydration and Nutrition: Supporting Skin Elasticity

Your diet during pregnancy impacts your skin’s elasticity. Staying hydrated and consuming nutrient-dense foods that support skin health can make a difference. Key nutrients include:

• Vitamin C: Found in citrus fruits, strawberries, and bell peppers, it supports collagen production.

• Omega-3 fatty acids: Found in fish, walnuts, and chia seeds, these fats help maintain skin elasticity.

• Zinc: Found in nuts, seeds, and legumes, it aids in tissue repair and regeneration.

6. Optimal Birthing Positions: Reducing Perineal Strain

The traditional supine position (lying on your back) may not be the best for preventing tearing. Research indicates that upright positions, such as squatting, kneeling, or being on all fours, can reduce perineal strain and allow for better control during delivery.

The Emotional Side of Tearing

Physical preparation is crucial, but addressing the emotional side of childbirth is equally important. Anxiety and tension during labor can lead to tighter muscles, increasing the risk of tearing. Relaxation techniques, such as hypnobirthing or prenatal yoga, can help you stay calm and focused.

One mother, Jessica, shared her experience:
"With my first baby, I was so tense during labor that I ended up with a third-degree tear. For my second, I practiced mindfulness and breathing exercises, and it made such a difference. I felt more in control and didn’t tear as much."

What If Tearing Happens?

Even with the best preparation, some tearing may still occur—and that’s okay. The good news is that most tears heal well with proper care. If you do experience a tear, your healthcare provider will guide you on recovery steps, including:

• Keeping the area clean and dry.

• Taking sitz baths for comfort and healing.

• Using prescribed medications or over-the-counter pain relief if needed.

Conclusion

While perineal tearing (or ripping) can be a concern, proactive measures such as perineal massage, warm compresses, pelvic floor therapy, and mindful birthing techniques can help reduce the likelihood and severity. Remember, every birth story is unique, and even if tearing occurs, your body is resilient and capable of healing. Focus on preparing your body and mind, and trust in the incredible journey of bringing your baby into the world.

If you need a little extra support, we’re here for you.