3rd degree tears
What is a perineum?
The perineum is the area between the genitals and anus. During childbirth, this fleshy area is strained as birth your baby. The pressure can lead to tears in the perineum.
“But what if I tear?”
According to RCOG ( Royal College of Obstetricians and Gynaecologists) “Up to 9 in every 10 first time mothers who have a vaginal birth will experience some sort of tear... for most, these tears are minor and heal quickly”
This is a common fear that birthers have, fortunately, the vagina is designed to accommodate baby.
What is a 3rd degree tear?
The Royal College of Obstetricians and Gynaecologists (RCOG) defines a 3rd degree tear as 'extending downwards from the vaginal wall and perineum to the anal sphincter'. Therefore a 3rd degree tear is an injury to the vagina, perineum and anal sphincter.
How common are 3rd or 4th degree tears?
Overall, a 3rd or 4th degree tear occurs in about three in 100 women having a vaginal birth. It is slightly more common in women having their first vaginal birth, compared to women who have had a vaginal birth before.
What increases my risk of a 3rd or 4th degree tear?
For third- and fourth-degree tears, there is often no clear reason why this happens, and it is not possible to predict. However, it is more likely if:
This is your first vaginal birth
Your baby is over 4kg (9lb)
You have a long second stage of labour (the stage during which you push your baby out)
Your baby’s shoulder gets stuck behind the pubic bone (shoulder dystocia)
You have an instrumental vaginal birth (forceps or vacuum assisted)
When researching what factors make a 3rd degree tear more likely the above list is commonly what I found, however According to evidencebasedbirth podcast the main factor that can influence your risk for having a tear is actually the provider or the person who is attending your birth as a healthcare worker. She goes on to explain that the less interventions (forceps/vacuum) then the better chance you have to not tear. They on to state that another factor that can increase or decrease your chance of tearing is your birth setting.
“on studies on planned home births, tear rates can be much lower, especially for severe tears.”
There are two main principles involved in reducing the chance of tearing:
A slow birth of the baby through the vagina – allowing time for the tissues to respond and stretch
Capacity for stretch and ‘give’ in the tissues
In researching this topic I found a study 'Fear causes tears - Perineal injuries in home birth settings. A Swedish interview study ' which I think summed up my findings in general about tearing during childbirth.
:For the midwife it helps if they know the birthers fears and birth preferences, that if a birther feels calm and relaxed her perineum relaxes. No rushing of the birth and listen to the birther, helpful upright birth positions, A warm cloth can help blood flow to the perineum and aid stretching process.
How does hypnobirthing help?
Knowing your birth science can help massively, by keeping your jaw loose and relaxed the rest of your body will follow. It is really helpful to do some hypnobirthing techniques at this time.
Doing some visualisations, reciting some positive birth affirmations or saying a power word can be really helpful. Certain positions can help reduce tearing. Such as kneeling, lying on your side or being on all fours.
My body will stretch to accommodate my baby
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