Minimising Tearing
How to Minimise Tearing in Childbirth.
As a midwife and childbirth educator, one of the most common concerns I hear from expectant mums is the fear of tearing during birth. The perineum is an incredible part of that body that can stretch and heal incredibly well. There are a number of ways to reduce the likelihood and severity of tearing and support your body. By incorporating hypnobirthing principles, pelvic floor awareness, and specific birth techniques, you can help prepare your body for a smoother birth experience. Here’s what you need to know.
1. Engage in Pelvic Floor Exercises (But Don’t Just Do Kegels!)
A strong and balanced pelvic floor is crucial for childbirth. While Kegels or pelvic floor exercises can help with pelvic floor strength, it’s just as important to focus on relaxation techniques. Seeing a pelvic floor physiotherapist during pregnancy can help ensure that your pelvic muscles are both strong and capable of releasing tension, which is key to allowing your baby to pass through smoothly.
2. Practice Hypnobirthing for Relaxation and Control
Hypnobirthing teaches deep relaxation techniques that reduce fear and tension during labor, which can minimise tearing. When we are tense, our muscles tighten, including the perineum. Learning to breathe through contractions, using visualisation techniques, and maintaining a calm mindset can encourage your body to open gently rather than resisting.
3. Use Optimal Birth Positions
Lying on your back can increase the chance of tearing due to pressure on the perineum. Instead, consider positions that reduce perineal strain, such as:
Side-lying – This allows for more controlled crowning and reduces pressure on the perineum.
Hands-and-knees – This position can help baby descend with less force on the perineal tissues.
Squatting (with support) – Opens the pelvis but should be done carefully to avoid rapid delivery. Your midwife or birth partner can support you in finding the best position for you.
Ultimately, birth in the position that feels most comfortable to you.
4. Warm Compresses During Crowning
A warm, wet compress applied to the perineum during the pushing stage can improve blood flow, increase elasticity, and reduce the risk of tearing. Many midwives use this technique to help ease the baby’s head out gently.
5. Breathe Baby Out Instead of Forced Pushing
The traditional “hold your breath and push” approach can increase the risk of tearing. Instead, “breathing baby down” using long, slow, controlled breaths—helps the perineum stretch gradually, giving tissues time to expand naturally rather than forcefully. Follow your body’s lead and urge to bear down.
6. Prepare Your Perineum with Massage
Perineal massage in the final weeks of pregnancy may help improve the elasticity of the tissues and reduce the risk of severe tearing. From around 36 weeks, use a natural oil (such as almond or coconut oil) to gently massage and stretch the perineal area. Regular massage helps you become familiar with the sensation of stretching and increases blood flow to the area, making the tissues more pliable for birth. Don’t aim to stretch the area painfully, but rather to breathe and relax the area when you feel pressure.
7. Work with Your Body’s Instincts
Your body knows how to birth. Instead of fighting against it, tune into your instincts. You may feel a stretching sensation as your baby is crowning. Instead of pushing harder, take deep breaths and allow your baby’s head to emerge gradually.
8. Stay Hydrated and Nourished for Tissue Health
Well-hydrated and nourished skin is more elastic. Drink plenty of water and include nourishing foods like broth, leafy greens, and vitamin C-rich fruits in your diet to promote tissue health and repair.
9. Postpartum Perineal Care
If you do experience a tear, proper postpartum care is essential for healing. Ice packs, sitz baths and pelvic floor therapy can support a faster recovery. the area has fantastic blood flow and does heal very quickly. Be sure to see a pelvic floor physio after birth too!
Final Thoughts
Minimising tearing during childbirth involves a combination of preparation, body awareness, and birthing techniques. By practicing perineal massage, using hypnobirthing relaxation methods, working with a pelvic floor physiotherapist, and birthing in optimal positions, you can reduce your risk of tearing and your fear of tearing and have a more positive birth experience. Every birth is unique, but by trusting your body and being prepared, you can support a smoother and gentler birth journey.
