And as a mom of seven, I'm here to help you take the guesswork out of childbirth so you can make the choices that are right for you and your baby and write the birth story of your dreams. So hit subscribe and let's replace your anxiety and fear with complete confidence. Quick note, this podcast is for educational purposes only and does not replace [00:01:00] your medical advice from your provider.

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Whenever I pull my audience and ask, What are you most afraid of when it comes to birth? Number one, it's always the unknowns, or being coerced by your providers, or not being listened to by your providers.

Well, maybe not that many, but lots and lots and lots of babies. I'm going to tell you this insider tip right here. It's not that bad. Vaginal tearing is not as bad as you fear. The fear of it, the anxiety, the things you think of in your mind, is a lot worse than it actually happening. So we're going to break it down today because I want you to stop worrying about that.

We're going to talk about what it is, what it isn't. We're going to talk about some ways that you can decrease your chances of a worse tear. Now, did I say prevent? No. You can't absolutely prevent it, but we're going to talk about some ways that you can lessen your chances There are some things that are inside your control and then there's some things outside of your control So we're going to go over it all at the end.

You're going to take a nice deep breath And when you release your breath, you're going to throw your hands in the air and you're going to release this fear. I also have a really cool download ebook, a little guide to tearing and an action plan is included in it. You can go to labornursemama. com forward slash tearing to get it and, you can check it out and have a nice little guide to tearing.

All right. So what is tearing? Tearing is exactly what you think it is. It is a tear to your lady bits. Let's talk about how often do people tear. Depending on your risk factors, the stats say that 9 out of 10 first time mamas are going to tear. Now the type of tear is dependent on you and your situation.

However, the majority of women have a first degree or second degree tear. Those are the most common. So we're going to talk about the types of tearing. The ones that we should be a little more wary of are the third and fourth degree tears, but not many mamas do. Get those. So I don't want you to worry about it.

It can be sore. I mean, we're talking about your vagina. The healing part can be a little sore. But girl, you're going to stock up on those postpartum supplies and I'm going to have a link in the show notes to everything I talk about, so don't worry about taking notes. But you're going to want to have your padsicles, I'll give you the recipe.

You're going to want to have your EpiFoam. You're going to want to have your peroneal spray. You're going to want to have your dermaplast. You're going to want to have all of these things so that this is not a huge deal during your postpartum recovery. Now, second degree tears, they affect the muscle of the perineum and the perineal skin, so they go a little deeper.

However, like I said before, they can be sore. A 2nd degree tear is going to take you a little longer to heal, but I promise you, it's not horrible. Now, 3rd degree tear. These are the ones that get a little more complicated. However, they're very uncommon. Very uncommon. So I don't want you to be stressing about this.

The External stitches usually dissolve within a few weeks, like two weeks tops, but the internal may take up to 12 weeks. This type of tear can also cause you some pelvic floor issues, so I recommend to my girls inside Calm Labor Confident Birth that they ask for a referral or they contact a pelvic floor specialist and go ahead and be on top of that girl, you want to make sure you are ahead of it so that you don't have any problems.

No fun at all. So you're gonna have all the way from the vagina to the booty, and it's pretty intense. It usually is repaired in the operating room. So they're going to take you to the operating room, clean you up, and it takes about three months to heal as well. And it most likely will cause some pelvic floor issues.

You need to be educated. I want you to know. what the types of tears are. So kudos to you. You're learning that right now. And I want you to know what you can do to care for them. So this is something I'm going to have in the show notes. We're not going to go into too much detail, but there's a couple of things I recommend that you get.

This is valuable to have. They are amazing. It's a little like tub thing, looks like a mini baby bath and you sit it in your toilet and you have very warm water in it and some of them have like a bag with a Catheter that comes down like a tube that comes down and it replenishes it with more hot water And you just can really clean and soothe the area.

I love them The other thing you want to do, like I said before, is do some padsicles, prepare them ahead of time. I recommend to my girls 6 to 8. Typically, my mamas who go over 8 to 10 usually have too many and have them left over. So make a nice batch. You're not going to want to use them for long. The other thing I recommend having is tux pads and EpiFoam.

Use it. Word of caution. When you use it, make sure you don't touch yourself with it. I have to tell my patients all the time because they'll put it right up there and get the tip on their vagina. You don't want to do that. You're setting yourself up for infection. So make sure you hold it a few inches away and before you sit down on the toilet or have your partner or someone Fill it up with nice warm water.

And after you go to the bathroom, clean off with that and then pat dry. You don't want to rub if you have a tear.

It heals so beautifully. I want you to think about this. When you're pushing your baby out, if it needs a little more room, then the vagina is made to tear a little to accommodate the baby. Do not be worried about it. This is what we want to happen if the baby needs more room. Now, there are some things that you can do to help prevent that from happening.

Like that is the best thing to get nice glowing Skin that's healthy. So I want you to remember that when you're thinking about vaginal tearing and birth in general Two of the most powerful things you can do. We're going to talk a little bit more about some other ways that you can help decrease your chances of tearing.

However, I want to talk about the risks. So we're going to talk about that first. What increases the risk of vaginal tearing? Here are some things that can increase your risk. We're not going to go over them all, but we'll talk about some. A big baby. So a big baby usually means a big head. There's two ways that you could potentially prevent a big baby.

And I don't want you to worry about that. Your body made this baby and your body can push this baby out. Now talking about diet and Nutrition, if you gain a lot of weight, so that's another risk factor, a high weight gain. So again, eat a healthy diet. Don't fall into the trap of you're eating for two. Eat healthy.

Any use of assisted devices? Like forceps and vacuums, those can all increase the chance of a vaginal tear or a more significant tear. So, One of the ways that you can decrease the likelihood of an assisted device is to keep moving, to get on your hands and knees, to get on your side, to get into a position that isn't a flat on your back with your feet in the air, which if you follow me on Instagram, I'm labor.

This position is called lithotomy, and it's asinine that they expect us to do that when we're having a baby, like, who in the world would ever lay flat on their back, put their feet up in stirrups, and try to poop when they're constipated? Pushing a baby out is the biggest constipation in the world. So why would you do that?

It makes no sense. And I'm getting fired up now. Hopefully that you'll, appreciate this, but you do not have to push in the thought of me. And if your provider says, well, that's how I do it, then you can say, well, that's not how I do it. And they cannot force you to get in the thought of me now in an emergent situation, if there's something unusual going on, that's different because it does allow them to clearly see the playing field.

And I teach those students that we do not allow. You hear the words I'm using. Not let allow, because you're the boss, you're the birth queen. We do not allow them to do anything out of convenience. or curiosity. So you need to be educated. You need to take some sort of birth class, and I don't recommend a hospital provided one.

Uh, no. I tell my girls also, there's no hard no's or hard yes's in labor. You have to be educated. You have to understand why would we need to use a forcep? Why would we need to use a vacuum? When is it appropriate? When is it necessary? Girl, I promise you if your baby's heart rate drops down in the 40s and things are looking scary, And you've tried position change, they've, if you're on Pitocin and they turn it off and you've done all that you can, you've got oxygen on, you've got fluids flowing, and the baby's heart rate's not coming out and they say to you, if I use a vacuum I can have the baby out in two seconds.

So, Learn, be educated, knowledge is power, knowledge is power, but only if you apply it. Okay, that's what happens when Trish gets off on a tangent. Sorry. Another risk factor is your first vaginal birth. Your road has not been paved. And someone has to pave it. So guess what? Baby number one is paving the path for all the other babies, like a little bulldozer.

So, you know, you might tear with your first baby. But again, what did I say? Once you say it out loud, it's okay. It's not a big deal. I'm gonna tell y'all right now I've had six babies unmedicated and I tore and had an episiotomy Because my doctor was an a hole with my first and I didn't feel either When you're pushing and when the baby's head is applying pressure onto the perineum, it kind of numbs it.

But if you are unmedicated and you're worried about this, let it go. You're not going to know either. It's not going to affect you. I promise.

Things that increase your chances that are sort of in your control and sort of not, but there's also some choices that you can make during childbirth that will decrease your likelihood of tearing. One is going unmedicated. Unmedicated patients are less likely to tear. This is not completely evidence based, but there are a lot of people who believe that, and from my career, this is what I've seen.

Most unmedicated patients can kind of. guide the pushing based on what their body's telling them. So, if you are planning on an unmedicated delivery, this is another reason to go with it. If you're planning on an epidural, girl, do not go unmedicated because you're afraid of tearing. That's not the way you want to do it.

This is a dialogue you want to start having with your provider early on. If you go into your 20 week appointment and you say, Hey provider, I want to talk to you about pushing positions. Because I don't want to push in lethotomy and they say, oh, well, that's how I push all my patients. It's safer. It gives me more Opportunity to help you if something's wrong.

We don't want something to happen to the baby Then girl high tail it out of there and find a better provider. If your provider says something like oh, we've got time Let's talk about it later. Girl, high tail it out of there Or say, no, I'd rather speak about it now because chances are they're putting you off because they're going to put you into lithotomy or try.

Now, would she have gotten one if she pushed in the position she wanted? We don't know, but chances are she wouldn't have because she was pushing in the way her body was dictating. She was listening to her body. Just like when we go poo poo, no one comes in and tells us to move around and get in a position that's convenient for them.

We do it according to our body. You have rights. You have rights. In fact, when you get admitted into the hospital, guess what? They're going to tell you all about your patient rights, but then they're going to act like you don't have them. Now, all, do, does all of them know I don't want to act like everybody does?

Now, this is why you want to have a good relationship with your provider. This is why you want to trust your provider, so that when they do suggest You can filter it through your education, the birth class that you took, and you can filter it through your instincts and make a wise decision together. But you have to trust your provider.

You have to know that they want what's best for you. Because I hate to break it, not all of them do. It's a business. And, you know, in their defense, we get used to doing things a certain way when we're in a business. It's not that they're doing something to harm you, but they might just be doing what's better for them or what they're used to.

There should be a need. Now, be respectful when you're telling them your wishes. But don't be wishy washy. There are different positions. Upright positions, which use gravity, which are the best for your birth and for your birth to progress and to make your contractions more effective and to get baby out quicker.

However, upright positions, some of them increase your chances of tearing. Now, me personally, as a labor nurse, and if I were your virtual doula, or you're in one of my birth classes, I'm gonna say, girl, pick a position that works effectively. Don't worry about tearing. However, squatting increases your chances of tearing.

More blood flows to your labia when you're in an upright position. So it makes more sense, right? The traditional old school, most doctors want to do it, lethotomy position, is the highest chance of vaginal tearing. Like, let's ask men when they are going poop to lay back on their back, put their feet in the air in a stirrups, and poop.

None of them would do it, right? Why were we asked to do this? Well, I hate to break it, but it goes all the way back to some pervert king in France, I believe, that wanted women in that position. It was a position that had originally Oh, goodness. What surgery was it? Gallbladder removal? I, I don't remember.

I mean, I don't even get it. Most of the partners and daddies do not even want to look down there. So I, I just don't get it. But you know, there's always that one weirdo and that one weirdo affected the rest of our history of maternal care. We need to change it. Let's stop it, and the only way it will change is if we all speak up and say no.

During my births, my unmedicated births, I used so many different positions. I would move around according to what my body was saying, and I would use positions to relieve pain. But, when it was time for the baby to actually come out, now I might have been pushing and squatting, I might have been pushing on my hands and knees, or standing next to the bed, or what have you.

They can use either hands or Gloved, obviously, or they can use warm compresses on either side of the, the perineum to kind of put pressure there to help when the baby comes out. Now that is dependent on your position because you're, if you're squatting, no one's going to get down there and lay under you.

It's no problem. This is not a sterile environment. This is a vagina Another thing that I want to talk about, because I get asked this all the time, is what about perineal massage during delivery? I am a huge fan of it during pregnancy, towards the end of pregnancy. In fact, I teach my girls this. But, you do not want to do it during birth.

This is something that can increase the likelihood of your vagina tearing. When they massage it with oils or KY Jelly or whatever, it can increase the blood flow and increase the friability and you might tear. So girl, don't let this happen. If they start doing this, you're going to have more bruising and more tearing.

I almost got to have a water birth when I was pregnant with Gavin. That was the plan. They still did it at my facility. I was in the tub almost to the end and then I got a hair up my ass, which is called transition, the biggest hair up your ass, and I got out of the tub despite the fact that everyone was like, you wanted to do it in the tub.

If my coach would have been a little more firm and reminded me that I was incredible and I could do it. And then I wanted to do it on the tub. I think I would have stayed in the tub, but I got it. I got a little moody and got myself out of there. Another thing that you can sort of prevent is controlled pushing during the delivery of the babysit.

That being said, this girl right here never did. But I didn't tear with anyone but my first. When the baby's head is coming out, it's best if it goes at little increments and stretches the perineum as it moves out. However, and you'll understand me, come back and say, Yep, Trish, I gotcha on that one. When the baby's head is stretching out your perineum, the last thing you're thinking about, Oh, is let me do this nice and slow.

If you have an epidural, this is something you are more likely able to do without really knowing that you're doing it. So just listen to your body. If you have an epidural, listen to your nurse, she's going to coach you and guide you. I don't want you, holding your breath, counting to 10 or all of that.

Just listen to your body, do what you need to do. Even if you have an epidural, you can still listen to your body. I highly recommend That you, like I said, take a birth course, take a class that teaches you all the positions so that you can practice during pregnancy so that. You know, I can't tell you 90 percent of the women that I've delivered.

So practice while you're pregnant The best thing that you guys can do, and I've said this over and over again, is education, good nutrition, but let's also talk about some exercises.

My golden nugget of an exercise that I recommend to all my students. Do a deep squat. I'm not talking about like with a barbell, like a big old giant man. I'm talking about Like a yoga squat. So Google yoga squat. I'll have a graphic in the show notes to show you what I'm talking about. When you do a deep squat during pregnancy, I want you to start.

If you're a week away or you're eight weeks pregnant. This is like an all over wonderful thing to do to prepare yourself for birth. This is something my mama told me. My mama's from Kentucky. She's very southern. She's told me a lot of weird things. But this one she did tell me. And she happened to be completely right.

She told me to do everything squatting. She told me to hand mop my floors with a rag and to watch TV, to read a book squatting, and even though I was very young, which is, we'll talk about later. I actually listened to my mom on this and did it and pushed incredibly. So deep squats, they prepare your, your perineum.

We have all sorts of classes and all sorts of fun things planned inside of there. Tons of support. And what I tell my girls is challenge themselves. So when you start, it's going to be a little harder, build it up. But I want you get to a point where you take something that you love doing.

Like, let's say you love scrolling Instagram and looking at all my new content. Hopefully. Or you love watching some binge show on Netflix. I want you to get to a point where you only watch it or only scroll or only do that thing while in a deep squat. That'll be your challenge. And build up your time.

Get moving. Go on walks. Do all the things. Now, another thing that can help you is being confident and being prepared so that you won't be fearful or tense during birth. Tension leads to, or fear leads to tension. Tension leads to tight muscles. Tight muscles, when you're tense and you're fearful, you're going to build up more lactic acid, so that also leads to more pain, but it also leads to worse tearing.

we know what a vaginal tear is and you're probably a little bit anxious still and a little, uh, not too happy about your vaginal tearing. I get that. The main deal again of this episode, this entire podcast episode, is that you have to confront those birth fears head on. Let go of the fear of tearing.

We fear the unknown. We fear a threat. Birth is not a threat. Tearing is not a threat. It's what your body is supposed to do. It's the amazing way your body will make room for your baby. The one you built right there inside of you and the one who has to come out. The one that you've probably been saying, get the heck out of me.

Just like if your baby needs a little more nutrients while you're pregnant, they're gonna take it. That's just the way it's supposed to happen. That's how our body works. And it's pretty damn incredible. So get rid of this fear, girl. Another part of this, before we end this episode, is that I know y'all are worried about your vagina stretching at all.

Let go of the rest. Don't worry. Hey mama, I hope you enjoyed this episode of the birth experience with labor nurse mama. If you loved it as much as I did, then head over to labor nurse mama dot com forward slash tearing and And check out all the information and all the resources that I have together in one spot just for you, including a free Taring guide that you can download right now.

And let me know how much you love this episode by subscribing to my podcast and writing a review. I would love to hear from you. Have a fantastic day and I'll see you next Friday.