We’ve all seen some movie scene or the other in which a woman’s face contorts in pain as she pushes during labor, surrounded by a chorus of ‘push, push, PUSH!’ But did you know that unnecessary pushing during labor can cause tears? Yes, from your eyes too. But we’re specifically talking about damage to your vagina. That’s why it’s crucial to learn how to push during labor without tearing.

Vaginal Tearing During Labor Due To Pushing

Nine in 10 women suffer from some kind of vaginal tearing during normal childbirth. The damage varies greatly. But in the worst cases, women can be left suffering from incontinence and lifelong nerve problems.

Between 2013 and 2014, there was a steep rise in the number of women in England who suffered from perineal tearing. The perineum is the section of skin and tissue between the vagina and anus. This led the Royal College of Midwives to take some form of action.

With the support of the Royal College of Obstetricians and Gynecologists, they piloted a trial program at Medway Martime Hospital in Kent.

During the trial, the conventional pushing during labor was not advocated. A simple change such as not pressuring women to lie on their backs and ‘push’, went a long way. Basically, how to push during labor without tearing, was to minimize pushing altogether.

The hospital reduced the number of third and fourth-degree perineal tears by seven-fold, from seven to just one percent!

The hospital’s head of midwifery, Dot Smith, attributes the alarming number of women experiencing vaginal tearing to the misconception that women have about the need to “push, push and then push harder” in labor.

“When we saw 22 cases of third-degree tears in a month, we said, this is is not good enough,” Smith said.

During the trial program, the hospital also encouraged women to give birth by standing up, or squatting on their knees. This was normal and widely practiced until the 1950s.

How to push during labor without tearing: Until the 1950’s, it was common for women to give birth while standing or squatting.

Midwives also encouraged breathing naturally through contractions as a way of how to push during labor without tearing.

In addition, as opposed to the conventional method of pulling the babies out as soon as their heads emerged, the midwives allowed the baby to follow the natural birth rhythm and come out at their own pace. They supported the weight of the baby to reduce pressure on the perineum.

As you can guess, the program was a hit. It was so successful that the findings were published in the European Journal of Obstetrics and Gynecology. There are also plans to implement these practices nationally.

A simple measure has already made such a significant impact on reducing unintentional damage to the bodies of women in labor by 85% in some maternity wards.

How to push during labor without tearing? To push or not to push…

In her article To Push or Not to Push, Mickey Morgan, founder of HypnoBirthing, says that pushing during labor is counterproductive.

“Forced pushing creates stress for the birthing mother, which is self defeating in that it closes the sphincters of the vagina ahead of the descending baby.”

About 25 years ago, Morgan introduced the concept of mother-led breathing, as opposed to staff-directed breathing and pushing.

She has found ample evidence that directed or forced pushing results in:

Fatigue for the mother in labor
Increased morbidity of both mothers and babies
Inefficient uterine surges or contractions
Increased risk of hypoxia (depriving the body of adequate oxygen supply)
Fetal heart rate anomalies
Damage to the mother’s pelvic floor muscles
Rupturing of eye and facial blood vessels
Tearing of the perenium
Increased need for episiotomy (surgical cut at the opening of the vagina)

The results of this study are hardly surprising for midwives and gynecologists. But, it is great news for women everywhere that finally these methods are getting the formal recognition that they deserve. Pushing during labor can be damaging and there are safer ways for women to labor.

It’s good to be well-informed about such things for most first-time mums go into the labour ward not really knowing what to expect. Keep this in mind when the big day comes!

Reference: Cochrane Library

Also read:

Perineal massage: A guide for pregnant moms

4 vaginal birth positions: pros and cons

Episiotomy: All you need to know about that “scary” vaginal tear

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