A common factor among clients I work with is a fear of tearing during childbirth. I often get the question, “Is there anything I can do to keep my vagina from tearing?” as well as “How bad does it hurt?” and “Is there really a ring of fire?”
There are some ways you can support the labia and the perineum (the skin between the vagina and the anus) to stretch gradually in the hopes of preventing a tear during the second stage of labor, or the pushing phase. Your bottom is put under a very large amount of pressure as your baby is born, so it is no wonder that small lacerations are fairly common during vaginal birth. Keeping it 100: Yes, there is a burning sensation as the baby crowns, which is why it is called “the ring of fire.” It is not a comfortable sensation. However, pregnant people push babies out all the time with success, and you are about to learn how you can best prepare for those sensitive moments.
Labor down. If possible, it can be helpful to wait until you feel an unmistakable urge to push, even after you are completely dilated. You will continue to have contractions as you have been, and eventually a feeling will come over you as baby descends and begins to put pressure on the perineum. It can be described as feeling involuntary, or reflexive. This is a great way to push as well when you have an epidural.
Use a warm compress. You can ask your nurse, partner or doula to help you apply a warm compress to the perineum as you are laboring down. This can help ease the transition by encouraging you to soften and relax.
Labor in the tub. Utilizing warmth and water during labor helps many women soften and prepare to stretch. Lots of people find it very calming and helpful for coping with contractions.
Blow through the ring of fire. This part can be challenging, but it is important to allow baby to crown gradually to allow your skin to stretch. Calmly blow the air out of your mouth as you exhale. Know this part is temporary.
Guidance from your OB or Midwife. At a certain point during the second stage of labor, your Ob or midwife may tell you to stop pushing. They are watching out for you as they support baby’s head as it emerges, and can tell when you are at risk for a tear. They may tell you to stop momentarily to allow your body to catch up before continuing.
Sometimes tearing happens even after strong efforts to prevent it. Your medical team and doula are there to support you! Remember that if you do need some stitches, you can consider using nitrous oxide to help to take the edge off as they are administered. This option is currently available at Vanderbilt, St. Thomas Midtown, and Baby + Company.
Check out this breathing tip to help you avoid tearing during the pushing phase of labor.
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