New moms are often confused, scared, and just don't know what to make of the state of affairs under the belt when they go into labor. You hear horror stories and...well, ladies, sometimes the stories do have some truth to them. What happens below the belt during labor can be much more than you would have anticipated. Having been through three labors and having witnessed two natural births of plus 9 pounders, I'm here to give you the run down on the topic.
When you are going through labor, you are dilating your cervix and the contractions are pushing the baby down the birth canal. As this happens, it causes the head of the baby to crown and the whole pelvic floor is stretched. You may recall that you are encouraged to do kegel exercises to strengthen it. As much as you should strengthen it you should also relax it in order for it to stretch. When the baby starts to come out, some times it can come out so quickly and with so much force, especially as the shoulders come out that it can cause your skin in and around the vaginal area to stretch and sometimes tear. It really depends on factors such as the size of your baby, his position, the speed of delivery, and how stretchy your pelvic floor and your skin is.
The tearing can be the worst part of the recovery post baby. It is however very common and not something to be too bothered by if it happens. The doctor or midwife will tell you if you have torn and the extent of the tearing. If you get stitches you may feel tenderness and have bleeding postpartum. You of course will have medication to relieve the pain but when the medication wears off and you use the restroom you may experience pain. If the tearing has torn towards the anus or gasp....into it, that is when you may have a lot of pain when having to 'go' postpartum. Luckily, your body will often defer that function naturally for a while after delivery. After delivering you have to also learn how to breastfeed and take care of the baby and tearing and dealing with its aftermath can be a lot to deal with all at once.
What can be done to prevent tearing? Kegels are one part of it but also, perineal massage is extremely helpful in prepping the area to stretch during labor. Using a good quality skin oil can help a great deal in making sure the skin is as responsive and accommodating as possible when it's go time.
My first pregnancy I teared moderately to severe and I had the worse recovery of all of my three pregnancies. Going to the bathroom was difficult and I was very tender for more than a week. I could not do much because of it. My second pregnancy I did perineal massage and during my labor, I had a midwife who was using mineral oil to massage as the baby was being delivered. Because of these two factors, I had no tearing and the recovery was so much easier! I was up and about a day after.
My third pregnancy, I was a bit lazy and thought it would be easier the third time around and I also thought...well the midwife was massaging and oiling so maybe I don't need to do too much. Unfortunately the third time she did not oil or massage and I asked her to do it to help but the baby came too soon for that. He came out pretty smoothly however when his hand came out, it caused a tear. It is often the shoulders that cause it because they are the widest part of the baby's body when coming out headfirst. I did need stitches for the third labor and my recovery was also a bit harder than when I didn't tear. I also had some clotting from the placental delivery that I didn't experience before which also made my recovery more challenging.
In hindsight, I wish I had done more perineal massage (I also was not as fastidious to take my prenatal vitamins as I did with my first two children, I was just barely getting by, ladies!) but you know, when you are in the third trimester, it's not so easy even reaching down there and I know they recommend dad helping with that...but....well, you're welcome to try that if it works!
Postpartum, it is really important to start kegeling again as it will help you in restoring your muscles that control peeing. Moms will often notice that if they laugh too hard, they sometimes pee a little...also, if you go to one of those trampoline houses, things will definitely feel different. Kegels are important in bring your muscles back and preventing minor incontinence.
Wow, I'm making labor sound so great, right? Well, the cutie patootie that you'll fall in love with as a result will make it all worth it! And, just remember, our bodies do get wear and tear even without babies. We moms have our battle scars and wounds but we are also really diligent to try to get back to fit and I'm sure with a LOT of sweat AND tears, you'll be back to your pre-pregnancy state.
Well, best wishes for your recovery! Drop me a note and let me know how your delivery went!