Preventing Perineal Tears: OB/GYN Shares Evidence and Tips About Protecting Your Bottom

This week, Dr. Sarah Bjorkman, a board-certified OB/GYN, and Dr. Kurt Bjorkman, her board-certified pediatrician husband, share medical expertise, research data, and personal experience about preventing and limiting perineal lacerations (tears) from vaginal child birth.
Study references used for this episode cited in video.
Speical resources for mom's preparing for vaginal birth with guide on perinal massage can be found at: www.royalberkshire.nhs.uk/med...
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Also check out our video: The Best Pain Control for Birth -- • OB/GYN Explains Epidur...
Intro Music: A WAY FOR ME - Nicolai Heidlas by Chem Ocampo
Keywords: pregnancy update, the doctors bjorkman, first trimester pregnancy, second trimester pregnancy, third trimester pregnancy, fourth trimester, pregnancy vlog obgyn, postpartum, postpartum recovery, laceration, birth trauma, perineum

[@katiemurphy3601]

For anyone who's pregnant right now...the first 2 babies I tore but my 3rd I didn't! Here's what I did different: My first baby came out with her hand over her head. Couldn't really prevent that. But I was laying flat on my back and that didn't help. Tmi but tore internally. Second baby was on my hands and knees. That relieved a lot of pressure! Still tore some. I tried pushing too hard and didn't wait until a contraction to push. Third baby the midwife put a warm washcloth compress down there while pushing and that made a WORLD of difference. I didn't use pain meds but still didn't feel the "ring of fire" because the wash cloth was so relieving. I also pushed on my hands and knees, and waited for a contraction for the final push. She also came out with her hand over her head like her sister did, but still no tearing at all and I recovered very fast. Maybe this will help even just one mama. ❤️

[@AvatardSwag]

I'm not pregnant, but as someone terrified of tearing, this helps a lot! Thank you!

[@jacquelyn6799]

I am due in a few weeks with my third! I tore with my first two as well. I honestly thought everyone tore when they gave birth 🤦 I'm hoping to try these tips and fingers crossed no tearing this time🤞

[@evam4182]

Thank you! I’m due in a few weeks and I’m terrified, especially for recovery 😵‍💫

[@preciousgem881]

Thank you for your comment. I tore the first 2 times as well. Currently pregnant with my third. Fingers crossed!

[@prayersponytails6227]

Yes, I second the warm cloth compress! I’m pregnant with baby #4 and have had 3 unmedicated labors, tore with 2, and I still get a little nervous about tearing.

[@Msrainbowzebras98]

I did perineal massages & my midwife placed a warm washcloth on me too while I pushed, I had a very minor tear that didn’t require stitches & didn’t even know of until she told me. Totally recommend it!

[@katiemurphy3601]

The warm washcloth was the best thing ever. 😆

[@tmichell1128]

So nice of you to share such an intimate experience! I’m first time pregnant and been watching all your videos! Thank you so much for the excellent content!

[@madelinej996]

Thank you both for your content!! I'm 13 weeks with baby #3 but it's always good to watch new info and review and I have been loving your channel this time around. Sidenote, you look so pretty, Sarah!

[@MeeshT]

This is definitely one of my biggest fears about giving birth xD I'm due in 6 weeks so definitely a video I appreciate and that comes just in time for me to be informed, make some decisions, and prep. Edit: I gave birth on the 16th, had minimal 1st degree tears :) still a bit sore but recovering easily

[@annasok1251]

Im due in about 6 weeks also!

[@angelicargz4813]

Congrats!!! Well, if this can bring a bit of peace of mind, we have so many blood vessels down there that the recovery is pretty fast. I had 2.nd degree tears and they were not overly painful, it was more like a pressure discomfort. Hoping everything goes great for you and baby ❤ God bless!

[@MeeshT]

@@angelicargz4813 thank you! It does bring me comfort - before hearing all the good stories about healing somewhat easily and without too much pain, I only heard the nightmare ones about bad tears and weeks of agony so I seriously started to consider an elective c-section. By now I’m more afraid of major surgery than a little tearing xD

[@angelicargz4813]

@@MeeshT oh absolutely! I'd say a C-section wouldn't be justified at least for me. I know we are all different. But in my case all I needed was time to do my sitz baths and actually trying to go to the bathroom. I did not use a numbing spray postpartum and don't feel like I needed it. As long as you have enough support pp and a freezer full of meals, all you'll want is to enjoy your bundle of joy all the time. You got thid mama!

[@clockworkhearts4085]

I had a second degree tear and a urethral tear. I had an epidural so didnt feel it until it had already been stitched, but it really wasn't that bad. 6/10 on the pain scale when getting up, 4/10 on the pain scale when staying still or moving. by the time I was out of the hospital it was only a mild discomfort. ice packs and pain meds took care of the pain in those first few days. it took a few weeks to heal, but it all healed back together perfectly and sex felt completely normal by 6 weeks. the scar faded really quickly too and stayed completely flat and very thin.

[@user-uu1sg8ht1x]

It's cute how you both keep looking at each other, it's like you're struggling to not look at each other when one of you is talking.

[@danielleburns9803]

Would love to see a video on birthing positions. And also positions to help with managing pain during labor.

[@lisasteinhauser6293]

I love you guys! Your channel helps me with my pre delivery anxiety. Science rocks!

[@nicolebaxevanis7345]

Thank you for being so honest with your post birth story 💓 Im pregnant with my third, its reassuring to know even a professional can experience the lulls of motherhood, great tips

[@perimomperinealmassager-pe1754]

We made Perimom (FDA cleared) so that any woman can do the massage completely unaided. Great video!

[@Karipaige]

I just want to say thank you guys so so very much for having this channel where you talk about real life situations that are completely normal in a "it's not a big deal" type of way because it really isn't! Currently 35 weeks with my first and have been watching your channel religiously throughout my pregnancy! Thank you for making this process easier to go through with your calming but reasurring ways♥️

[@TheDoctorsBjorkman]

You are so welcome Kari!! And congrats on being almost done with your pregnancy! The exciting stuff is just around the corner. Send you love and luck for a smooth labor and birth!!

[@danieller3098]

To any mother out there, or person present with a delivering mother, this one is for you. After 3 (soon to be 4) homebirths, here are a few methods I believe helped me have zero tearing or bruising for my 2nd and 3rd birth. Fist let me say, i had tearing my first birth, however I feel like the degree could have been smaller if I did not listen to my midwife and push as hard as I could at the end. I went down onto one knee and kind of canon balled her out instead of allowing the gravity and my body to open. That being said, birth 2 and 3 were unassisted, just me and husband at home and this quiet space was so beautiful and intuitive. Most of the time was spent on the bathroom floor, hands and knees, towel underneith my knees, and a large stuffed animal/pillow or cushioned stool to lean into when contractions were hard. This provided a sense of "control" being on Top of the wave vs drowning sensation. It also helped me progress rather quickly into full dilation. I'm talking 3 hours vs 20 hours. Towards the end into transition I felt this extatic sensation to push and that's when my water broke. Then the babies came down through the cannal and both times there was no forced pushing, but instead a desire to almost slow down the baby. Still on my hands and knees, my tail bone naturally tucking and upper body slightly raised up as I provided counter pressure and aloud my labia to stretch and open, like a snake eating, however opposite. And finally a small push for the shoulders, but nothing too harsh. I swear the forced pushing is one of the most flawed recommendations. First this frustrates and exhausts a woman more then necessary. Second, there is a clear sign internally in the body that only the woman can detect. I hope this message can help even one person, especially someone in the medical field providing support for numerous woman.

[@puredust5797]

Whata power 🔋 couple! Thank you for all you do! Going on 3rd trimester,💪🏽

[@rileymccollister]

I freaking love you guys. I found you when you just started out and was pregnant at the same time as you! Very helpful!

[@TheDoctorsBjorkman]

Awww thank you so much!! And hope your pregnancy went well and motherhood is being good to you! It's a wild/exhausting job but it's pretty darn great. :)

[@ankitaminhas4372]

Oh my! I can literally feel the pain even though I’ve never had a baby or not having one anytime soon.

[@kristina282k]

Awesome video! It’s sad that in many countries episiotomy is still a daily practice, regardless of what the data says, done most of the time without the patient’s consent or knowledge just to reduce expulsion time and to make the doctor’s work more easy after birth as it is easier to repair a surgical cut than a “natural tear”. Massage on! 😊

[@michellean893]

I’m so happy I saw this because I was planning on buying an epi-no device! Great advice here

[@timtamtoni5037]

"I'm not having fun, motherhood sucks." The thesis statement of post delivery body maintenance. 😂

[@TheDoctorsBjorkman]

Always trying to keep it real over here. :D

[@suseq949]

@@TheDoctorsBjorkman That’s what we want; reality, not fluffy feel good non helpful nonsense. TY.

[@AReineyMay]

I’m sure it’s not a huge factor but our instructor told us to support the baby’s head as it comes out of the perineum to reduce tearing potential

[@JavaMuko]

KZbin recommendation on point. I was just thinking I need to look into this last night

[@karamcqueen7063]

Avoiding pushing too hard & too long. I eventually got an epidural with my daughter so I couldn’t feel the contractions coming and the nurses coached me when to stop to breathe and I didn’t listen. I just kept on pushing hard for a very long time. I tore a lot down there but recovering wasn’t so bad but just giving you a ladies a heads up on what not to do lol.

[@Onikaannbeautiful]

I had no tearing which I 100% give credits to my midwives for! they used warm cloths and some kind of oil on my perineum the whole time I pushed

[@lacey2906]

I had a 3rd degree tear, and I had no idea. It didn't hurt during delivery when it happened, and it didn't hurt in the hours after birth. No epidural, completely drug free birth. I was nervous to get stitches, but they numbed me up good and I only felt the first prick. The itching and pinching of the stitches afterwards was uncomfortable, I had to be careful how I sat and got up, but no painkillers were needed other than the initial stitching. So, it's great to prepare against tearing, but also try not to be terrified of it. Fear is worse than the thing itself imo.

[@TheDoctorsBjorkman]

Thank you so much for sharing Lacey! Sometimes not knowing what to expect can cause a lot of fear too, so we hope by educating and hearing experiences like yours women can feel empowered and prepared and fearless!!

[@miguin7877]

Thank you that helps alot

[@corgimom5626]

This is honestly very relieving to hear. Thank you for sharing.

[@jeanedarc]

I love their honesty with the peridium massage and the husband not being a fun!

[@TheDoctorsBjorkman]

There’s definitely more “fun” ways to spend time together… but it was for the team. :)

[@trap.princessred3628]

Mine said NOPE . And I didn’t even ask I was just watching this video 💀😂 thank god I can reach myself

[@user-dd1em8lv9y]

I am from Bulgaria and I have recently read an article written by a bulgarian doctor who recomends the use of almond oil for both perineum massage and during the birth itself. According to him it lowers the risk of tearing up to 40% by making the tissues more flexible. I don't know if the info is credible but it doesn't hurt to try, I certainly will.

[@TheDoctorsBjorkman]

There actually is some data that almond oil is helpful for stretchmarks too!

[@sueylove9750]

I really wish this video was out before I gave birth 😢 I got a 4th degree tear last year as a FTM. I was rush to the OR before serve swelling. I honestly never knew about the degrees of tearing. I am 7 month pp. doing well but weak pelvic, so I’m doing pelvic floor exercising. Thank you guys for this video !

[@alllllleeexxxxxxx]

This was a fantastic video! I suffered a 4th degree tear 18 months ago with my first child and I wish I would have been able to see this video prior. Currently 20 weeks pregnant with #2 and going to try perineal massages in 3rd tri but I suffer a little ptsd from my tear and recovery and the thought of a perineal massage makes me a little sick to my stomach. Could you cover that a little in your next video? For any pregnant women who are scared of severe tearing, this is just my experience but I healed quicker than I would have though and made a full recovery after a few months. With nothing to compare it to, my experience wasn’t really that awful. I did see a pelvic floor physical therapist and I believe that aided in my recovery immensely and would highly recommend.

[@pichichisosa3110]

How long did it take for you to recover from your 4th degree tear?

[@ambersmith1176]

I had a baby a week before this videoncame out at exactly 39 weeks, (17 was my due date) and I had no perennial tears this delivery or my last! Thank goodness.

[@mariesounds9543]

Did you have an epidural or natural?

[@SuperSkyheart2]

I needed this video 6 weeks ago

[@marisavogt115]

Thank you for the information currently 36 weeks with baby girl hope all is well for you and your family ❤

[@TheDoctorsBjorkman]

Marisa--you are most welcome! And good luck to you! You are almost there so sending you all the vibes for a smooth labor!!

[@sarahmestiri1855]

I had a 3rd degree tear in my 1st pregnancy. They did episiotomy. I was in shock! And the recovery wasnt easy at all... hoping this time with my team of midwives, we can work together to prevent it! They told me about the warm cloth and perenium massage.

[@ehussain88]

Hi there, thanks for all your videos! My husband and I find them SO useful! I had a question about pushing techniques with an epidural. Any recommendations or resources?

[@mrs.michellesgarden2489]

I think it helps a lot to do the massage. I did it with both my pregnancies and had no tears. I did it once a day with coconut oil in the shower. I also brought my own water to the hospital (I do not like chlorine) and went through quiet a bit. It is annoying to have to pee so much but in my opinion keeping hydrated keeps your skin supply and more elastic.

[@mahamujahid9978]

How you did the massage? Like how often and in which position

[@BloodyVK]

When did you start doing your massage? Is it in 34 weeks?

[@taliamay93]

^ oo I wanna know the above answers too!

[@shisho861]

Was a great video, I will soon experience childbirth and I am glad I came across this video to have an idea of something I can do

[@shisho861]

Especially a female ob/gyn that just gave birth for the first time, I feel that there is truly empathy and a genuine effort for researching material even outside the American school. Great video!

[@arayategan9218]

Thanks for posting!

[@suseq949]

I’m glad you mentioned the fact that the stitching/repair should not be painful. In too many cases the doctor doesn’t numb adequately or even at all! It’s unconscionable. Please remind women and emphasize this whenever you can during your videos.

[@cornishtea32]

I'm 6weeks postpartum and I had 2nd degree tear. They numbed me but when he got to stitching my perineal skin, I felt everything. It hurts so bad. And my healing has been rough from feeling pain on the area to getting an infection and needing antibiotics.

[@suseq949]

@@cornishtea32 That’s really awful. So sorry you are going through this; hope you’re healed and feeling good soon. It stinks dr couldn’t stop and inject more local anesthetic. I do not understand why they keep going when their patient is in agony.

[@vanderbam2741]

Have had 2 babies with no tearing. I was walking around throughout labour but delivered semi-reclined. First was 7lb 7, second was 8lb 9. I think a good midwife, guiding your pushes well, makes a big difference. (Not in the US) current midwife thinks anecdotally that personal skin type/elasticity is a big factor.

[@jonesfamilyfarms9325]

Just popping in to say that I’m 5’2, 130 pre-pregnancy and have birthed 7-8lb babies. I haven’t torn at all, and I’ve been using red raspberry leaf tea from Pink Stork and taking evening primrose oil vaginally and orally. I told my sister about it and she started it at 28 weeks- just had an 8lb baby with the biggest head I’ve ever seen on a baby and she didn’t tear either!

[@hbc2k11]

Ive been hearing about EPO. Thanks for sharing!

[@christinamewitz2284]

Im 30 weeks pregnant and very appreciative of this video as well as all the others you both make. Thank you!!

[@LisaSnow3]

I’m 31 weeks so I understand you completely.

[@lakeynvanmatre1383]

30 weeks, too!! Good luck at the end of January, bump buddy! ❤️

[@TheDoctorsBjorkman]

You are so welcome! I know tearing was a big fear of mine and did lots of research to see if there was anything I could to do prevent it!! Just wanted to share with all of you. You have got this mama!!

[@TheDoctorsBjorkman]

@Lisa Snow January baby!! Congratulations and good luck to you--you totally can do it!! Hope the last few weeks of your pregnancy are being good to you!

[@TheDoctorsBjorkman]

@Lakeyn--good luck to you mama!! You're gonna rock it.

[@Wanderlust4Marisaki]

This was very helpful, thanks for sharing guys!

[@TheDoctorsBjorkman]

Glad it was helpful!

[@gabriellahopping975]

When is the “labor positions” video coming out? I can’t wait

[@mercymuriuki8404]

I wish partners would be open about their relationship the way they are.Sometimes it's tmi to the world but you should be like that with your partner💓Much respect💚

[@birthtraumamama]

One thing I really wish was mentioned is that even if you do everything "right" and take evidence-based precautions, there's no guaranteed way to prevent tears of (any severity) during a vaginal birth. My birth plan included a warm compress, no episiotomy, a birth position of my choosing, and self-directed gentle pushing, but my baby had prolonged bradycardia and shoulder dystocia, so literally all of those measures went out the window in order to save her life. I had a 3rd degree tear and was so unprepared to deal with that devastating injury. It never even crossed my mind that the preventative measures might not work or that they might not even be possible due to emergency situations. I know most don't have to think about those things because their birth is uneventful, but it would've been helpful to at least be aware of the possibility as a first-time mom.

[@juliakbrown]

Thanks for flagging this. All these measure “reduce the risk” of tears, but reduction in risk doesn’t mean it can’t still happen. It just means that a lower percentage of women who did these things had tears than the percentage of women who didn’t do these things.

[@stella9624]

Was a C section not an option at that stage for you, mama? I'm so sorry you had to go through that ❤

[@birthtraumamama]

@@stella9624 C-section was brought up, but my OB said it was safe to continue vaginally if we could get my baby out really fast, so I went with his recommendation. By the time it turned into a shoulder dystocia a c-section was the last resort (because the baby is partially born and pushing a baby back inside is very dangerous). I just learned too late that women can be severely injured during a vaginal birth and/or suffer from long-term complications as a result. I thought a vaginal birth gave me a 100% chance at total recovery, so as long as my baby was okay I wanted to avoid a c-section for the sake of my health and recovery... which obviously was the wrong decision for me in hindsight. Fortunately we are both doing well now (though it took me a few years)!

[@amandaakatukunda]

A really useful episode!

[@TheDoctorsBjorkman]

So glad you think so!

[@KJxxoo]

I’ve had 4 babies... never did any “prep”. I only ever had 1 tiny tear with the second, and i believe that was because I went crazy with the pushing and I was on my hands and knees. The other 3 I had more controlled pushing and was on my back. I believe it’s more to do with allowing the baby’s head to slowly stretch things out as they are being birthed. But that’s just my belief based off my own 4 birth experiences.

[@chililow]

What do you mean by controlled.pushing? ?

[@Elizabeth-gb2tk]

Loved this! Thank you! Can you do a video on how to prevent a pelvic organ prolapse?

[@arayategan9218]

yes! Second this!

[@ednaramos727]

A What?!? 😧

[@myrkaortiz1268]

Can you please make a video going more into detail about perineal massage? How often, what products to use, how to do it? My boyfriend and I would love more info so we can do it properly when it’s time!

[@TheDoctorsBjorkman]

Hi Myrka. Here is a link to a guide on how to do perineal massage--there are pictures! Everything you want to know is at the bottom of page 2 into page 3!! www.royalberkshire.nhs.uk/media/d0mimkeu/preventing-perineal-tears_sept21.pdf

[@charityrussell4558]

I’m almost 22 weeks pregnant and so nervous to give birth. Thanks for this video!

[@Jiyehyena]

Same 😥

[@elizabethj6534]

Read Ina Mays guide to childbirth! That book was AMAZING and gives you ALL the confidence epidural or not!

[@mrssalvadorena503avalos7]

Same !! I’m about to be 23 Weeks

[@ndreader]

Also around 22 weeks too. Getting pretty nervous here too.

[@laurenskee2665]

I promise you. The closer you get the more the fear of birth goes away.

[@ashtonlong2485]

I got super lucky and only needed on stitch but my daughter is also only 5 lbs 13 oz. My doctor did massage me the whole time so I’m sure that helped. I’m 1 week postpartum and feel great.

[@nicholascheung680]

Thank you! Learned a lot

[@mzp_honey]

I met a young lady at work who gave me tips when I was about 2-3 months pregnant to start using olive oil in the perineal area, I did and am so thankful that I didn’t tear giving birth! I think between the oil, having an epidural (making it easier to push) and the way I pushed all helped. Thank you Lord!

[@letsgoalready5515]

What way did you push?

[@ololadeshadare3888]

Hi did you start using olive oil as early as 2 months?

[@lucyreds1917]

Can you do a video talking about placenta previa? Thank you!

[@Mamaisawake]

Id love some information on risks for peri urethral tearing. Everything I read is on perineal tearing. The healing was so slow compared to what I hear about recovery from perineal tears. I’m nearing birth again and this is honestly my biggest dread for the whole birth experience.

[@lillian592003]

I work as a NP in this field and am loving your videos. After a few years as a L&D nurse and 2 unmedicated deliveries myself, I would say really good control of pushing is definitely possible with no epidural.

[@TheDoctorsBjorkman]

Oh thank you so much! And thanks for being here with us. Totally agree, control is absolutely possible without an epidural and things I've seen mamas use that helped them were focus points and having worked on breathing techniques prior to their labors. Alsoooo a supportive partner/midwife/doula is a game changer if that is a goal!!

[@Bornman86]

@@TheDoctorsBjorkman I am going on 33 weeks and my little one is doing well. But his head is measuring 2 weeks ahead which will impact my birth plan. Will the growth slow or will I know at my next appointment a bit more?

[@TeaCup1940]

I know a mother that had two births. The first one at the hospital semi sitting in bed, no epidural or any other pain medication, the husband was holding one leg up and a nurse the other one. The nurse did a Kristeller maneuver without consent. She had internal vaginal tears that needed stitches for about half an hour. The recovery lasted around 8 months. The second birth was a precipitous one. Labour and delivery took 2.5h. She did not get to the hospital bed on time and gave birth at the hospital's parking lot in a squatting position. The husband was the only one that assisted the birth. Again she had internal vaginal tears that needed stitches and the recovery took about 4 months.

[@TheSydrit]

Thanks for the video and very helpful information. Am 34 week now but am a little nervous about child birth.

[@TheDoctorsBjorkman]

It is SO normal to be nervous. I'm an OBGYN and have delivered HUNDREDS of babies and I was nervous!! Talk to your mom and sisters and friends who have had babies so you know what to expect--that always helps me. And know that you CAN DO IT. Your body is amazing. So trust your body and the team that is delivering you and you will have a great birth.

[@LaMexicanaBonita95]

Had two babies so far, and never tore with either delivery. I don't even know what I did lol Glad though!

[@elleharrop1526]

I read the thumbnail as tears… as in 😭 crying tears 😂

[@emilyhogg6941]

I would love more specifics on the perineal massage! How often, where to massage, whether to use an oil/lotion, etc! Thanks for all the great info you guys provide!!

[@yaniwet]

Yes, please!!

[@joytsai8050]

Same! That would be great

[@sunshineasare285]

There you go ladies. Have a safe delivery

[@Dove.Love.]

There's a brochure in the notes. Has answers to all your questions.

[@micliltang]

Massage frequently after 34 weeks begins until birth, anytime you massage an area always use a skin lubricant such as oil/ lotion.

[@eslo2308]

I tore upwards into a vein with my last pregnancy. It was soooo painful and scary. My mom told me I lost a lot of blood. 😣 Now I'm worried because I didn't think to start these massages earlier on.

[@kingasandi4860]

Thank u for the video 🙏🏻. Can u pls talk about the phases in labour?

[@TheDoctorsBjorkman]

Hi Kinga! Yes--we covered that and talked all about labor in this video kzbin.info/www/bejne/poS0nYlrjaaNp7M

[@teamgumatay496]

I am currently 34 weeks pregnant. Thanx for the tips. I will try the perineum massage and hope it helps limit the tears. Thanx..new subscriber here

[@TheDoctorsBjorkman]

Congrats on your pregnancy and welcome to our channel! We are so glad you are here! The perineal massage is definitely a little awkward at the beginning but hopefully it helps and gives you confidence that you can absolutely be ready for labor!! You are so close!!

[@rebeldreadd93]

Tomorrow I’ll be 35 weeks and I’m really worried about tearing 😩 I’m glad I found this video and I’m going to keep trying to find other methods to avoid them. This is going to be my first child 🥺

[@mainanawacho5322]

I'm 35weeks and freaking out

[@kreiselsina]

Same!!!

[@bergemarie3249]

Have you been doing the massages...did you give birth yet? Hope all is going well

[@mainanawacho5322]

@@bergemarie3249 I did and I had a 2nd degree tear. I'm still doing sitz baths 1 month after having my baby. It probably could have been worse coz my baby was 4.2kg so I wouldn't discredit this

[@bergemarie3249]

@@mainanawacho5322 omg.... I wish you a speedy recovery

[@NYCHICLIFE]

I was side lying and didn’t tear. My epidural was so strong and couldn’t feel anything and so my body pushed the baby on its own and crowning naturally. So by the time i pushed once my perineum stretched and baby was out in one push.

[@NYCHICLIFE]

So 5 weeks postpartum with baby number 2. Was induced again this time 36 weeks last time 37 weeks. I pushed on my back and did not tear. Labor was 2 hours from start of pitocin and water breaking to baby. First time it was 4 hours. Made sure to control my breathing and pushing during crowning and had a mirror.

[@wingolamo]

When I saw the thumbnail for this in my feed, I saw "Prevent Tears During Birth" and my first reaction was, "Is this some new trend? Trying not to cry while giving birth?! Good Luck with that!" LOL! 😀

[@morganchapman2150]

I had just turned 16 when I had my Daughter. She's almost 9. When I was in labor just before starting pushing, maybe around 7-8 centimeters dilated, my mom was talking to the mid-wife and was like "pleas cut her, don't let her tear". That mid-wife said "oh don't worry none of that will happen". She came back with a GALLON of Bertolli olive oil! She started pouring it all over my lady bits and went to town. My mom said it looked like she was kneading bread 😂 but guess what? I didn't tear and she didn't cut me. I didn't tear during my 2nd birth either.

[@stephanieguthrie5186]

Thank goodness for that midwife and olive oil. Also my doctor cut me and it was horrible healing process. I still tore. Stupid doctor.

[@dvmjess]

That’s it I’m bringing the Bertolli to my delivery lol 😂

[@kimikojade]

NOTED! PACK OLIVE OIL IN HOSPITAL BAG 😆

[@byJessCh]

Im due next month, gonna include my extra virgin olive oil to the hospital bag 🤪

[@hollydaugherty2620]

Tell us you didn’t give birth in an actual hospital without telling us. 💀

[@albamonjegallego2812]

thank you so much for this video!

[@TheDoctorsBjorkman]

You are so so welcome Alba. I know it was something that was super important to me, so wanted to share!!!

[@NursePractitionerLena]

I had a severe tear with my 1st child and had to get pelvic floor PT for 1.5 years. I'm watching this vid hoping that I don't have a major tear with my 2nd one.

[@Jessica-gg7ol]

Helpful information. I think the video should also include the stats: 1. Epidurals increase the risk for tearing and 2. Women who are induced with Pitocin are more likely to ask for an epidural due to an increase in pain.

[@TheBooty28]

In some hospitals you just have no choice in the end. Things just happen. I just feel like women were designed to have babies. After thousands of years we are still having this as an issue. We are clearly doing something wrong. Animals seem to give birth without any issues. Maybe our birth processes are too artificial. I have heard that getting epidurals actually increase the chances of tearing because you are out of touch with your body. In the past women had alot more kids than we did one after the other. I feel like there is something we are doing wrong. Tearing should be preventable and no vagina should have to be cut open. The fact that doctors are starting to say this now means there are things we are doing wrong now that will also be abolished in the future.

[@BoldMathTutoring]

It totally makes sense that the epidural increases the chances of tearing for the reason you say. Notice that these studies about massage and birthing positions were done mostly on women with epidural so they do not really tell much. OB/GYNs are not trained enough on natural birth so it makes sense that so much is missed around it. When an OB/GYN uses epidural and tears herself it makes it look like women are doomed to tear and to not be able to have a normal natural birth. Not to mention the effect which birth has on breastfeeding. This is not an attack on her, she seems very nice. I just wish there were more efficient ways promoted by specialists to minimize pain during childbirth and prevent tears.

[@vanderbam2741]

Well tearing is probably a natural part of the process too. In many women it would have healed fine and others would have died of infections. Also humans have an issue with birthing efficiently because our babies' heads are enormous in proportion to our pelvis, because our brains are so large. But yes a good medium of natural process and medical support is essential.

[@KEKrato]

@Dominique Monay Historically, a lot of women died in child birth, so I wouldn't say their methods were better

[@natashaarango2679]

Any tincture/oil recommended for perineal massaging ?

[@racheleirich]

i have seen evidence to suggest that a “hands off approach” (i.e., not touching or trying to support the perineum during birth) is actually less risky for tearing. a study from this year (2021) by Pierce-Williams et al. titled “Hands-on versus hands-off techniques for the prevention of perineal trauma during vaginal delivery: a systematic review and meta-analysis of randomized controlled trials“ in the journal of maternal-fetal and neonatal medicine found this. unsure about the impact factor of the journal but it seems well done.

[@dawnnelson7876]

Yes I was confused when they suggested the p. massage bc I'd been told it can actually increase risk of issues. I had 2 kids and no perineum tears. I did however have a small vaginal tear each birth. So much conflicting information either way! The 1st time I pushed while laying down(as told) and needed stitches. With my 2nd I was squatting and did NOT push and had a very minor tear that didn't need stitches.

[@sukanyabasu8164]

Study references only perineal pressure during active stage of labour. So I think perineal massage in the weeks prior to labour might still be helpful, haven't looked up those studies though.

[@sandrajones8245]

Nice and very informative video, I just read one person is interested in finding out more about the massage technique, which I second. And does age make difference? I'm 36 and may have first child, my brother who is 25 (same for his wife) has already had their first child but I'm not sure if she suffered any lacerations. I don't think she did since the baby came out whilst she was still at home (I think, I'm about 90% sure this happened).

[@tiffany9810]

I'm due in 7 weeks and am terrified about tearing or needling episiotomy. I was told my baby is measuring big and just got diagnosed with gestational diabetes and they made me even more nervous when they talked about GD babies being bigger. Thanks for the informative video!

[@jennifert8536]

This was very helpful! Will you happen to be doing an episode on induction of labor? I was just diagnosed GD and I was so excited about a natural (quick, if my mom's genes had anything to say about it) but now that's no longer an option. I'd love to hear about the process so it's not so scary and daunting. Thanks!

[@lacey2906]

Not sure if you've given birth yet or not but you should check out the "midwife thinking" blog. Dr Rachel Reed has a very interesting article on GD diagnosis as well as induction. Very informative.

[@jennifert8536]

@@lacey2906 Thank you! I appreciate that! I haven't, I do at the end of the month. I'll take a look!

[@musiclover-cn7tb]

I wish I had known this before I delivered my first child years ago I had no issues with my second.

[@neurotika]

I never received any advice and I too had a second degree tear. I don’t have leaking, though when I have to pee I sometimes have trouble holding it till I sit down, but I had that prior and I know a large part of it is a mental thing. The part that still bothers me is that my postpartum care was not adequate. I really felt dismissed and my ob was no longer there by time my appt came around. I’m pretty sure I didn’t heal well- I I think there’s some sort of vaginal prolapse occurring. My son is 5 now, I’ve only had one child. Intercourse can still sting (and even cause some tiny bleeding at times) and I think it’s from micro-tears along the scar. I’m definitely self conscious about it. I loved being pregnant, but the nightmare that was giving birth and post-partum misery has put me off of ever having another baby.

[@priscillawright660]

How often should you do the massages? Once a day? Once a week?

[@Aertistic]

My mother had an episiotomy with my older brother and the doctor cut so far down that it actually cut her sphincter muscle. This was back when episiotomies were much more common. I'm terrified of that possibility.

[@chelseareed7326]

Do you have any videos discussing if you have had an episiotomy with a previous birth? Will you need one each time if you’ve had one?

[@AmandaStapley]

I'm in the lucky 4th degree tear club :( but I'm fairly positive that's hard to avoid when forceps are necessary (cord wrap was preventing baby from leaving without too much cord compression. ) I am glad I had the epidural though, and I guess I'm a decent healer. I was uncomfortable sitting down but otherwise it wasn't too bad.

[@veet7530]

Will you do an updated video of what items you used after having the baby? Did you like the munchkin pail?

[@annafehr9560]

Thanks for the video. I was wondering, do you know if a water birth can prevent tears?

[@camipockets]

Am I the only one lucky enough to have a husband way into doing this massage? He was like, "I get to spend more time between your legs? Yes, please!" We just added it to our foreplay. My heart goes out to all those mamas whose husbands give them a hard time about this. I was really surprised to learn other husbands out there are not enjoying this, like, I really don't understand it.

[@PumpkinMozie]

I’m also lucky to have a helpful husband. will never understand men who give their partner a hard time or complain about helping with stuff like this. Like, that’s your effing baby she has to carry and deliver. Don’t you dare complain about the comparatively tiny things you have to help with. Get over it and do better.

[@camipockets]

@@PumpkinMozie Good for you! Super glad.to know we're not alone and glad you get that support too!

[@haleycowan1052]

I think my husband became more attracted to me when I became pregnant 😂 it’s been great!!

[@camipockets]

@@haleycowan1052 Heck yes!😁😁

[@daughterofthemosthigh8064]

I told my husband about the perennial massage and he reacted just like yours all excited about it lol and same I'm surprised to find out others aren't up for it too, I guess we are blessed, I'm thankful

[@atif7865]

Thank you for this great channel. Can you please comment on hemorrhoids and whether there is a risk of rapture during labour?

[@paulenenistal]

Omg! Same issue with me so double the worry😫😫

[@pemachoden6369]

I am 37 weeks now , is it late to start having perineal massage. Wasn’t planning before but now I want to after watching your video.

[@jennaom1]

Thanks for this video! My baby is 11 weeks old. I tried perineal massage toward the end of pregnancy but was not at all consistent about it. I ended up with a pretty standard second degree tear. I believe the nurse was massaging my perineum during pushing. Recovery has not been too bad; I don’t think I’ll have any long-term issues with urine leakage. However, it still hurts to insert things into my vagina (sex, tampons). Could you please address painful sex after giving birth and how to correct it, either in your postpartum perineal care video or in its own video? My doc suggested dilators to help loosen up the scar tissue, but I’m hesitant to try! I’d appreciate any resources you could share.

[@tashalovesponies]

Pelvic floor therapist!!

[@juliequates9529]

Yes a Pelvic floor therapist would help! Everyone should see on postpartum

[@TheDoctorsBjorkman]

Yes to pelvic floor physical therapist. They are amazing and I agree I wish everyone could see one postpartum. Ask your OB for a referral!! And thank you for the video suggestion--postpartum sex would be a great topic as nobody talks about it!!

[@fafa8985]

Thank you 🙏

[@soundsaboutright1004]

I’m currently 37 weeks with my second. My first birth left me with a very small tear and only two or three stitches.. but he wasn’t a big baby by any means. So I’m nervous with baby number two cause she’s already bigger than her brother. But I’m hoping for the best.

[@tablet6655]

Am I the only one who read "tears" and thought: How could you not cry while in labor? Before realizing it was the other "tears"?

[@JadaLyn14]

This is very off topic to what the video is discussing but I’m gonna leave this here anyways in hopes that you guys see my comment. 💗 I’m a first time mom at 40 weeks now and will most likely be induced tomorrow morning. I’ve been experiencing what I’ve now learned to be “Prodromal Labor” and I’m honestly surprised that I’ve never heard of it before. I looked it up on KZbin looking for more info but most videos are older or aren’t coming from a medical professional. I was wondering if this was something that could be discussed in the future? I’d love for some light to be shed on it. The contractions have been pretty painful for me, nothing like Braxton Hicks, and being shut down at my hospital visit and sent home because they haven’t caused adequate dilation has really left me devastated. I’d love to see it be talked about. 💗

[@ninana143]

This is crazy. Jenn Im (on youtube) didn't even KNOW she had a tear (1st time mom) she ended up in the ER a few days after birth due to the extreme pain!! There they found out she had a tear and she needed stiches!😱

[@Rundiamir]

I have been watching her videos for over 10 years...I didn't see her mention this story? Which video was it? I remember her mentioning which degree tear she had

[@allisonharding3054]

I had bilateral labial tears with my second baby (VBAC) and my stitches had issues dissolving too. It was really rough!

[@jamiehein3795]

Just curious as someone considering elective c section with my first baby due to my immense fears over tearing (not pregnant yet), in your experience which recovery has been worse?

[@ArabellasAdventure]

@@jamiehein3795 I’ve had both and C-section def was longer recovery. I had 2nd degree tears and stitches and I would take vbac over C-section any day!

[@amberlysoto]

I had Covid when I gave birth and literally coughed her out. I had second degree tearing due to that and she was only 6lbs 😩😩

[@lucygoosie7726]

I read this as “Preventing Tears 😭 😢 (like crying tears, not ripping tears) during childbirth” and I was like… “What’s wrong with getting emotional when you have a baby?” I had both kinds of tears! My son was holding onto his ear for the entire delivery (and for all my ultrasounds as well, so we knew that might be an issue). My labor was otherwise very smooth. I laboured from lunch till dinner and, in spite of his hand slowing the process, I only had an hour of pushing. But the tearing was bad. Edit: I should add that my tearing was on the side where his hand was and I didn’t even feel it till after he was born (and since I had him at home, I wasn’t on any pain killers, I was just numb from stretching) I thankfully didn’t get any other tearing and I did a lot of stretching/massaging beforehand.

[@keniciagold3630]

Hahahaha!! I did too!

[@1LovedbyHim]

Same here!😂😂😂

[@Sha_NaLeaaaa]

GIRL SAME!!! I was worried that I was the only dummy who thought that! 🤣🤣💀

[@drleneplant]

I'm one year post partum and just found out I'm pregnant again. I had a 2 degree tear which still hurts. Just thinking about pushing another baby makes me consider a C-Section but I'm going to apply these tips and talk with my obgyn about it!! I also heard filling condoms with water in the freezer help for postpartum

[@kortneyhepting5069]

What do you do with the condoms then?

[@sarahwhitman1026]

I’m pregnant with #2 going for VBAC, my c section was absolutely horrible recovery was extremely difficult

[@phan282002]

I wish I paid more attention to this video before I gave birth a few days ago. I got a 2nd degree tear with stitches. The midwife tried using mineral oil. With my first one, I had an episiotomy, and I remember it hurting more because I was unable to sit or move around much afterward.

[@oldschoolwoolandweavingcen4060]

I had 11 babies born at home with Direct Entry midwives. They ranged in size from 8.5 lbs ( #1 ) to 11.5 ( #11 ) getting bigger with each baby. 5 were 10 lbs +. No tears. I was free to move about and choose my laboring positions, some of which were challenging for the midwife, but perfectly natural for me. Guided strictly by intuition to find the right position. That said, having bred and raised sheep for years, I have seen countless ewes give birth without any perineal tears ( often to as many as five lambs at once ) and among my dairy herdsmen friends, learned it's not an issue for cows either. I've never seen it happen in a dog or cat or horse either. So then, my question is why is this such a routine concern? I would think by now the medical industry would have figured it out. While home birth and midwife assisted births seem to have better outcomes in this area, of course there will be those few cases of tears anyway, but tearing shouldn't be considered normal or something that is expected, let alone such severe ones as described. There is way to much fear surrounding birth these days and women seem to be losing touch with their bodies. Nowadays women don't seem to have any connection to their babies, jumping for sonograms to give them an image rather than using their God - given insinct to guide their pregnancy, labor and delivery as well as postpartum period. It's important for communities of birthing women to support each other, provide information and develop traditional wisdom to return birth back to the gift it is.

[@lisaa2104]

Interesting perspective. As someone who likes to combine both medical science (which indeed saves a lot of lives when things go wrong) and intuitive methods, what do you think helped you to deliver well?

[@KatyaFL]

You guys didn’t talk about drinking red raspberry leaf tea & using coconut oil for massaging. I would love more info, especially on the tea. Thanks, everyone.

[@polarbarr21]

Cajun Stork Midwife Kira has videos on Red Raspberry leaf tea. It’s recommended for 2nd trimester and third. In third, 4 cups are recommended to help prepare the uterus for labor. There’s also capsules if you don’t like the tea. The tea will tone the uterus like exercising other muscles to make it stronger and reduce postpartum bleeding. It may not help everyone, but it will not hurt you.

[@KatyaFL]

@@polarbarr21 Thanks so much! I found her video 💜

[@Rheasaha]

I had a third degree tear with my first born and 3 years later pregnant with my second one and considering c-section. 3rd degree was brutal and traumatizing.

[@yanababinov6953]

Oh my I could relate, I had third degree tearing 😢 also , it was awful . Recovery was 6 weeks 😪

[@lucygoosie7726]

My cousin had a 3rd degree tear with her first (a little 7lbs girl) then during her second pregnancy she got gestational diabetes and her son was over 10lbs (he came out looking like a chubby 3 month old) and not a single tear! She just took it slow and her body knew what to do and it stretched to accommodate. So tearing one time doesn’t mean that you’ll tear every time.