Episode 215 - Strategies to avoid tearing during birth

Reducing the risk of perineal and vaginal tearing during childbirth involves prioritizing physiological birth practices and informed decision-making. Key strategies include accessing midwifery-led care, practicing perineal massage from 34 weeks for first-time vaginal births, and adopting upright or side-lying positions to minimize pressure on the perineum. Avoiding coached pushing is critical; instead, allowing the baby to emerge slowly and gradually under the influence of natural maternal urges prevents unnecessary trauma. While warm compresses may reduce severe tearing, clinicians should avoid routine, non-consensual vaginal or perineal massage during labor. Ultimately, the body is designed to stretch and repair, and maintaining a calm, supported environment helps prevent the physical tension that often leads to resistance and tearing.