What happens if you DO tear during birth?
Dec 13, 2021In my previous blog, I talked about the different grades of tearing. With type 2 and greater levels of tearing, it involves the musculature and is a little more serious and intense. If you go home with some incontinence and need to use adult diapers, you might start to stress and cause anxiety. Do not panic, you can rehabilitate it and it does not have to be a permanent thing. It could last days or longer.
Do Not Do Too Much Right Away
FIRST TIP - Do not do too much right after you return home. There are different time frames for different scenarios of giving birth. If you had a home birth, you are already in your home after your delivery. If you gave birth at a birthing center, like what I had with my second child, I was allowed to leave within four hours from delivery. I chose to stay for 12 hours. If you had a vaginal delivery at a hospital, you might be able to leave after a day.
If you had tearing, wherever you had your delivery, you would want to get a peri bottle. It’s the bottle that you squirt water from so you can keep everything clean down there as you have an open wound. I would suggest getting a peri bottle that has an angled neck on it because the one the birthing center or the hospital provide you with usually does not have a neck. This seems like a little thing, but trust me…. It can be a game changer.
It’s best to already have the peri bottle even before you go into labor and put it in your hospital bag. You can even put the peri bottle in your baby shower list for convenience.
More on not doing much after giving birth, I recommend that you should not work out right away. You have a dinner plate size wound on your uterus. Just because you cannot see it does not make it any less intense. You also have a wound on your perineum. If you have had stitches, you need to wait until it has healed before you can try any type of perineal massage.
The ONLY thing I start people with right away is breathing. It might sound insignificant and not enough to help with the tearing, but it will help recalibrate your core and the relationship between your diaphragm and your pelvic floor. You want to think of the diaphragm as the top lid to your core and the pelvic floor as the bottom. They should reciprocate pressure. As you inhale, you want to feel your diaphragm depress and the pelvic floor takes on some pressure. Upon exhaling, the pressure comes up and it should no longer be on your pelvic floor.
When we are pregnant, our diaphragm gets pushed up higher and higher and it is not able to work like it normally does. That is why I tell my pregnant patients to do different breath work to encourage the diaphragm to continue to work as efficiently as possible even though it is lacking the space to do that.
After giving birth, you finally have the room that your diaphragm needs. This is the perfect time to slowly encourage the diaphragm to start doing its job again. This helps with our core function and waking up that dynamic system again.
I recommend doing different types of breathing because the brain likes novelty. There is not one type of breathing exercise that will help fix everything. You need to sample different kinds of breathing and mix it up.
Beside the pelvic floor and core engagement with post-partum, you have all these shifts such as center of gravity changes, your hormones are surging and are all over the place. It is a good thing to down regulate your nervous system by switching your fight and flight mode to rest and restore through breathing exercises, meditation, quality rest, and more.
As for not pushing yourself to be more mobile right away, I also give this advice in my core to floor restoration program. In this program, the first thirty days does not involve strengthening. It is more focused on breath work and mobility to release the pelvic floor. You want to slowly reconnect to your core. This is a good rule of thumb for post-partum moms too. It is fine to walk around the house with your baby, but to walk for exercise will be stressful on your pelvic floor and it might not be something you will be ready to tolerate right away. I know that walking seems SOOO easy, but it can be very taxing on your system after such a huge physical event like childbirth. I want you to stick with simple mobility drills, breath work, and some pelvic floor relaxation techniques. Here are some of the simple poses I’ve done on social media (link).
PELVIC ROCKING FOR ONE SIDE RELEASE
You can also do some light abdominal massage before doing the breath work to help connect to the core.
Note that if you feel like you have incontinence issues, prolapse issues, or anything like that, be slow to introduce the large amounts of light walking as it can still be too intense.
What To Do Once Your Tear Has Healed
Once your tear has healed, it will be very important to incorporate perineal massage. Similar to what was discussed in the previous blog, we want to slowly mobilize the area where the scar is. You can use your hands or a tool. One brand of tools is the intimate rose wand and I will be interviewing the creator of it for the podcast in January!
Some people will find it easy to lie on their back, in the tub, or have one foot up on a higher surface to reach into the front or from behind. If you are having a difficult time accessing the area, you just have to play around with the positions that you would be most comfortable in. You can also have your partner do it. Using a tool such as a wand can also help with reaching. Some tools can also add a vibration component and that can help with muscle engagement and recruitment in the area during that portion of rehab.
With perineal massage of your scar, you want to start indirectly. You can move the skin around it first. Move the skin on either side and up and down. Visualize working the most superficial layer of tissue first and gradually use more pressure to work the deeper layers. Do it slowly so your body has time to acclimate.
You can have tearing in the vaginal wall itself. You want to also try massaging from within the vagina. You can insert your finger or the wand in that area and lightly mobilize towards your tailbone and then out towards the bones we sit on. Try lots of different angles and take not of where it feels the most restricted.
If you are going to use a lubricant, you want to use a product with a pH level that is similar to your vagina. The pH should be 3.8 - 4.5. I used to be a huge proponent of coconut oil because it has no chemicals in it. It does not have the same pH level as your vagina. I would recommend looking at websites of different lubricant producers so you can check their pH level. If you are using a silicone tool to help massage the area, you would not want to use a silicone-based lubricant. Go for a water-based lubricant.
You can also use a coregeous ball or a foam roller for indirect massage. The different diameters of the foam roller make a difference. The smaller the diameter, the more direct it is on the pelvic floor. If you use a standard size foam roller, it will not fit between the bones you sit on and it will be a little less intense. For the coregeous ball, you can deflate it and sit on it. You want to rock forward and backward, side to side, and do some pelvic tilts. From there, feel the pressure it gives to your pelvic floor. If you want to increase the pressure, just inflate it a little bit more.
The sooner you start with these tips after the scar heals, the easier it is going to be for you.
Good Nutrition Also Helps
It’s necessary to have good nutrition and not starve yourself after having your baby. Some people forget to eat when their focus is honed in on their baby. You have to have enough nutrients and water postpartum.
The breath work, nutrition, hydration, and sleep will help you after giving birth. Another key factor is having a partner who is educated about all of these things. In the midst of postpartum anxiety or depression is NOT the time to have to educate your partner on the support that you need. I think that that aspect of birthing classes is not emphasized nearly enough.
Conclusion
After doing these things, you can slowly add in strengthening. This is important so that you can get back to doing the things that you love without having any issue. Until you start adding on demands to the body, you are not going to be able to successfully move into the activities you love. You need to challenge your system a little bit and prepare it to take on the extra activities.
Just remember that you need to be patient with yourself and slowly, but surely return into activities. Be as gracious with yourself as you are with others.
Hope these will help you!
If you have any questions, you can drop it in the comment section or you send me a message through Facebook or Instagram. I’d be happy to do another podcast about your questions. Also, if you want me to talk about something specific, let me know!
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Thank you for listening and see you next week!
