Tearing happens when the vaginal tissue struggles to stretch enough to accommodate the baby’s head, especially if the baby is large or the tissue lacks elasticity. These tears range from minor skin-level injuries to more severe ones involving muscles around the anus.
In the past, OB/GYNs would routinely perform episiotomies (surgical cuts that enlarge the vaginal opening) to prevent tears. However, this practice is less common now due to a better understanding of when and how tears occur.
While it’s impossible to prevent vaginal tears altogether, preparations during pregnancy can definitely help. Some tearing could still happen, but understanding how to reduce the risks should put your mind at ease.
At Desert Hills Care Center in Las Vegas, Nevada, these are some of the preparations we suggest:
Perineal massage involves stretching the vaginal tissue with the hands to increase its flexibility. Expectant moms or their partners can perform this technique during the final four to eight weeks of pregnancy. Research shows perineal massage reduces the risk of severe tears, shortens pushing time, and improves recovery outcomes.
Performing perineal massage three times a week is often sufficient to lower the likelihood of tearing. Always consult a health care provider before starting, especially if there’s a risk of early delivery or other pregnancy complications.
Kegels strengthen the pelvic floor muscles, improving overall muscle control during childbirth. Combining Kegels with perineal massage significantly lowers the risk of tears and reduces postpartum pain. Kegels also help reduce urinary incontinence during and after pregnancy.
Aim to perform Kegel exercises twice daily, holding each contraction for five seconds and repeating the process 10–15 times.
Certain birthing positions can influence the risk of tearing. Upright positions like squatting, kneeling, or lying on your side allow the sacrum (part of your pelvis) to move freely and reduce the likelihood of tears. Horizontal positions, such as lying on your back with the sacrum pressed against a surface, can increase the risk of perineal trauma.
Practicing birthing positions before labor can help you feel more comfortable using them during delivery.
Your prenatal care team here at Desert Hills Care Center will work with you to develop strategies for reducing tears during childbirth. These might include applying warm compresses to the perineum when pushing, performing controlled perineal massage during labor, and supporting the perineum manually as the baby’s head crowns.
Rather than pushing forcefully all at once, focus on breathing and pushing with a steady, controlled effort. Waiting for the natural urge to push and using breathing techniques can help the perineal tissue stretch more gradually.
Frequent vaginal exams during labor may increase the risk of severe tearing. Limiting these to medically necessary checks can help. Waterbirths or laboring in a tub can reduce tear severity by softening the tissue and allowing for smoother stretching.
In some cases, a carefully placed episiotomy might be a safer choice than allowing a severe tear.
Even with these preventive measures, vaginal tearing could still happen. Some level of tearing occurs in as many as 90% of first-time vaginal births, but most tears are minor and heal quickly.
Severe tears are less common and might require stitches and postnatal care to promote healing. Pelvic floor physical therapy and support from specialists can also help women recover from more significant injuries.
The body’s ability to heal from tears and episiotomies is remarkable. By taking proactive steps during pregnancy and collaborating with your prenatal team, you can feel confident and prepared for delivery.
Call us today to learn more about preventing vaginal tearing during childbirth. We also welcome online bookings and inquiries via the Desert Hills Care Center website.
