How to Reduce Perennial Tearing During Delivery (Anecdotal & Research-Based)

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My biggest fear with giving birth the first time was perennial tearing. 

Luckily I worked for a company which specialized in women's health during pregnancy so I had access to tons of scholarly articles. Which was perfect to do some research in how to avoid perennial tearing! Here is what I found: 

Research-Based Evidence

1. Mom's Position During the Second Stage of Labor Makes All the Difference

One study was trying to figure out how to quicken postpartum recovery and reduce tearing. It found that the best positions were not what you typically see in movies or on TV. (Actually that position, "semi-recumbent" is actually the worst when it comes to perennial tearing! Plus it's way harder for momma and baby too.)

The best position to avoid perennial tearing was on all fours! Second best was actually supine (lying flat with legs not bent up). This dramatically changed how I imagined my labor to go! 


You can see all the data in this chart:


Sources: 

Anecdotal Evidence

1. Mom's Position During the Second Stage of Labor Makes All the Difference (See what I did there?)

This was crucial to me! My first baby was born via C-section so I'm only talking about my 3 VBACs (Vaginal Birth After Caesarian) that I had after that.

  • Baby #2 — 9 lbs and some tearing but minor sutures and super speedy recovery
    • Position: All fours 
  • Baby #3 — 8 lbs 5 oz and very minor tearing but minor sutures and super speedy recovery
    • Position: All fours 
  • Baby #4 — 9 lbs 4 oz and still only one stitch! This was actually my hardest vaginal recovery (mostly due to attempts to deliver with forceps but regardless!). 
    • Position: semi-recumbent*
* Had to be in this position due to baby stress and to avoid another C-section

Now I know what you're thinking — “but if I get an epidural I won’t be able to deliver on all fours!” Not so, young momma. I had a epidural for every one of my deliveries. You just need to make sure your birth team is on your same page! It is totally physically possible. A few notes though:  
  • Make sure your anesthesiologist knows you want to be able to move and wiggle your toes (some call this a “walking epidural”). You won’t feel the pain of contractions but you’ll still be able to move your body somewhat normally too. 
  • Oftentimes the staff will give you a button to “turn up” the epidural as needed. Make sure you don’t overdo it here either. (But it should be painless still.)
  • Make sure your doctor/midwife/staff know your birth plan and goals! I usually messaged my doctor a few weeks before with a copy of my birth plan and then had a printed one with me for actual labor. This is my favorite template, which you can download for free. 
Positioning during the transition stage of labor made all the difference for me. But the SAFE PASSAGES acronym includes other helpful tips too (perennial massage weeks 36 up to delivery, warm compress during delivery, reducing fear and anxiety during labor, and more). 



Best of luck to you!! 

P.S. if you want liquid magic, just use the advice recipe my midwives gave me! It was incredible for my recovery.