[00:04:00] action plan is included in it. 


[00:06:38] Trish Ware: They usually don't cause long-term problems, neither first degree to errors or second degree tears. However, like I said before, they can be sore. A secondary tear is going to take you a little longer to heal, but I promise you it's not horrible. Now third degree [00:07:00] tear. These are the ones that get a little more complicated. 


[00:07:44] Trish Ware: 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 [00:08:00] recommend to my girls inside calm, labor, confident. That they ask for a referral or they contact a pelvic floor specialist. 


[00:08:33] Trish Ware: This is the most severe, but also the least common. It extends through the anal sphincter and into the mucus membrane, lining the rectum, no fun at all. So you're going to have all the away 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, [00:09:00] and it takes about three months to heal as well. 


[00:09:41] Trish Ware: 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 [00:10:00] recommend that you get. 


[00:10:29] Trish Ware: It's a little bit. Dub thing, it 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. 


[00:11:12] Trish Ware: The other thing I recommend having is tucks pads and epi foam. You can get these in the hospital. Hint, hint, any supplies we given you in the hospital ask for extra anything that is, um, reusable, we're gonna throw away. So take it with you. Take your peri bottle. It looks like a little mustard. It looks like a mustard or ketchup, like a, a condiment bottle with a point of. 


[00:11:56] Trish Ware: And before you sit down on the toilet or [00:12:00] 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. 


[00:12:44] Trish Ware: 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. [00:13:00] Do not be a 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. 


[00:13:38] Trish Ware: Like that is the best thing to get. Nice. Glowing. Um, skin that's healthy. So I want you to remember that when you're thinking about vaginal Tarion 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 tiering. 


[00:14:24] Trish Ware: If you're gestational diabetic, keeping those blood sugars in control, eat a healthy diet during pregnancy. All of you get moving, go walking, but you know what? If your husband. Is six foot six or like one of my students, your husband weighed 11 pounds when he was born and you were eight or nine bounds, then chances are, you're going to have a big baby. 


[00:15:16] Trish Ware: Another thing that can increase your risk, that you can't really control once you're pregnant is if you're young, really young or an older mama. So teens and older moms tend to tear a little bit more. I've been both. With my first, I was very young and I did tear and I got an episiotomy because my doctor was in a hole. 


[00:16:06] Trish Ware: Uh, flat on your back with your feet in the air, which if you follow me on Instagram, I'm labor dotted step mama. You know, I get into all of these soap stands or soap boxes, whatever you call it about big babies, about pushing and the pushing one really gets. Fired up. I don't understand why in the world that it is okay. 


[00:16:55] Trish Ware: Pushing a baby out as the biggest constipation in the world. So why would you do that? It makes no sense. And I'm [00:17:00] getting fired up now, hopefully that you'll appreciate this, but you do not have to push in lithotomy and if your provider says, well, that's how I do it, then you can say, well, that's not how I do it. 


[00:17:36] Trish Ware: That's just the. That's convenience. I teach my students inside both of my birth courses. I have one for VBAC. Mama's called the VBAC lab and one for everyone else called calm, labor, confident birth. 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. 


[00:18:20] Trish Ware: Told is the best way or led to believe. We don't want that. I want you guys to go against the policies. Be a rebel. Now, do we do it just Willy nilly at no, I tell my girls also there's no hard nose or hard yeses in labor. You have to be educated. You have to understand why would we need to use a forcep? 


[00:19:05] Trish Ware: And they say to you, if I use a vacuum, I can have the baby out in two seconds. Hell yeah. Use the vacuum, do it right now. But. If you've been pushing for a while and your doctor's like you've been pushing a long time. This might take a little bit longer. You want me to go ahead and put a vacuum on now? I don't think most doctors are going to do that, but there are some, then that's out of convenience and not for you. 


[00:19:59] Trish Ware: So, [00:20:00] 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 going to tell y'all right now I've had six babies unmedicated and I tour and had an episiotomy because my doctor was an a-hole with my first and I didn't feel either. 


[00:20:39] Trish Ware: I know when I say your vagina is going to tear, it sounds very painful, but I promise if you have an epidural, you won't know. 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[00:21:00] 


[00:21:28] Trish Ware: And for my career, this is what I've seen. When you have an epidural, you're not able to listen to your body. Per se while you're pushing, whereas a unmedicated patient who isn't flat on her back, who's listening to her body. Who's moving, who's listening to the pain cues and the different things and getting into a position that works for her body is less likely to tear and less likely to tear more significantly. 


[00:22:14] Trish Ware: If you choose unmedicated out of fear of other things, you're not going to have as good of an unmedicated birth as someone who really just wants to do it. So don't let anyone pressure you and don't let your fear drive. Another one that you can control is pushing position. I've already gotten off on a soapbox on this one. 


[00:22:58] Trish Ware: It's safer. [00:23:00] It gives me more opportunity to help you. If something's wrong, we don't want something to happen to the baby. Then girl Hightail it out of there and find a better. If you're providers is something like, oh, we've got time. Let's talk about it later, girl, Hightail 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. 


[00:23:48] Trish Ware: Now, would she have gotten one if she pushed in the position? 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 [00:24:00] to her body just like when we go poopoo, no one comes in and tells us to move around and get into a position that's convenient for them. 


[00:24:30] Trish Ware: And most of the time your nurses are all for you having your rights and doing what you want. We have no problem. There are some old school doctors and there's some doctors that hold to tradition and they have a harder time. So mama, you have rights. You do not have to do everything that you are told. Now this is why you want to have a good relationship with your provider. 


[00:25:15] Trish Ware: 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 bit. 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. And you know what, let's shake it up. The birth culture has to change. 


[00:25:53] Trish Ware: There are different positions, upright positions, which use gravity, which are the best for your birth and for your birth to [00:26:00] progress and to make your contractions more effective and to get baby out quicker. However, Upright position. Some of them increase your chances of tearing. Now me personally, as a labor nurse. 


[00:26:28] Trish Ware: Laying on your side or in lithotomy our horizontal positions, upright positions usually are less painful. They use gravity and they're better for the fetal wellbeing. However, they all mostly lead to vaginal Terri minus being on your hands and knees more blood flows to your Lavia when you're in an upright position. 


[00:27:16] Trish Ware: Well, I hate to break it, but it goes all the way back to some pervert skiing in France. I believe that wanted women in that position. It was a position that had originally, oh goodness. What surgery was at? Gallbladder removal. I don't remember something. Um, I'm bunking that one up, but it was a surgical position. 


[00:27:58] Trish Ware: So I, I just don't get [00:28:00] 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. Let's stop it. And the only way it will change is if we all speak up and say, no, during my birth, my unmedicated birth, I use so many different positions. 


[00:28:41] Trish Ware: So you can do that. My midwife respected me. My midwife listened to me. It's your. You're the center of the birth, do it, how you want and don't feel guilty about it. You're not doing anything wrong to say no. Now another thing that can be done during birth to help you out to keep [00:29:00] you from tearing is supportive. 


[00:29:21] Trish Ware: So now what I've seen with some unmedicated mamas and for myself, I have just naturally put my hands down there to support the peritoneum when the baby's about to come. I haven't seen a lot of doctors like kind of swap mama's hands away. So if that happens, be like, listen, I can touch my own vagina, get your hands away from me. 


[00:30:01] Trish Ware: 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 K Y jelly or whatever, it can increase the blood flow and increase the ability. And you might tear. So girl, don't let this happen. 


[00:30:47] Trish Ware: But however, waterbirth have been known to be as effective as epidurals for pain. I almost got to have a water birth when I was pregnant with Gavin, that was the plan. They still did it at my [00:31:00] 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. 


[00:31:26] Trish Ware: Which is why I have the coach class so they can know what to do because your coach has to coach you very differently during transition than any other time. During labor. If my coach would have been a little more firm and reminded me that I was incredible and I could do it and that I wanted to do it in the tub, I think I would have stayed in the tub, but I got, I got a little moody and got myself out. 


[00:32:17] Trish Ware: When the baby's head is stretching out your paraniem. The last thing you're thinking about, oh, is let me do this nice and slow. So that I don't tear what you're thinking actually is get the freaking heck out of me right now. And how quick can I do it? So if you want to push the baby out nice and slow and steady, then you may not tear me personally. 


[00:32:59] Trish Ware: I [00:33:00] don't want you, uh, 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 that you can practice during pregnancy so that, you know, I can't tell you 90% of the women that I've delivered. 


[00:33:47] Trish Ware: So practice while you're practice. 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 [00:34:00] exercises. 


[00:34:29] Trish Ware: As long as you don't have any kind of high risk for preterm labor or something, wackadoodle going on. If you do talk to your provider, always remember I'm not giving you medical advice. I'm just giving you educational advice. You always want to. But do a yoga squat. I want you to start right now, wherever you are. 


[00:35:05] Trish Ware: 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 paraniem. 


[00:35:48] Trish Ware: And, uh, all my students are in my community. And then on top of that, it's open to the public for a very low price. You can try it out for a dollar for a month. We have all sorts of classes and also lots of [00:36:00] fun things planned inside of there. Tons of support. And what I tell my girls is challenge them. So when you start, it's going to be a little harder, build it up, but I want you to get to a point where you take something that you love doing. 


[00:36:36] Trish Ware: If you can, you'll be so pleasantly surprised. I always recommend leaning against something or being near something that you can fall back on because girl, your center of gravity is going to get worse and worse throughout your pregnancy. This is something that absolutely will help you prepare for birth. 


[00:37:23] Trish Ware: So that also leads to more pain, but it also leads to worse tearing. So remember the calm, when you go into labor, have a shift in the mindset, re empower yourself, own your birth story. Tell yourself how powerful you are and how amazing you are. You can go into your birth without the sphere. I promise. 


[00:37:56] Trish Ware: Now we know what a vaginal dare is, [00:38:00] and you're probably a little bit anxious still and a little, uh, not too happy about your hoodie. Laterion 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 daring. 


[00:38:42] Trish Ware: Part of that coming out is your vagina stretching and maybe stretching a little more to make room. So even though we went over some ways that you can prevent it and ways that you can or choices that you can make, [00:39:00] the real deal is this. You can't actually 100% prevent it. If your baby needs more room, girl, it's going to take. 


[00:39:35] Trish Ware: It's not going to say stretched out. It's going to go back. It was made to go back. Uh, but again, good nutrition, good movement. Good fluid intake, preset fluid intake. Drink that water girl. Dehydration is a biatch when you're breaking. You are in control of what you're in control of. Let go of the rest. 


[00:40:29] Trish Ware: And let me know how much you love this episode by subscribing to my podcasts and writing a review. I would love to hear from you. Have a fantastic day and I'll see you next Friday.[00:41:00]