How to Prevent and Treat Perineal Tearing  – Conscious Birth and Wellness

How to Prevent and Treat Perineal Tearing 

By Joanne Fisher, BodyTalk Birthkeeper 

If you’re preparing for birth and concerned about perineal tearing, you’re not alone. Understanding what tearing represents, how it can be prevented, and what your options are for managing it—if it does occur—can empower you to make choices that feel right for your body and your birth. Remember, this is your birth, your experience, and you have every right to advocate for what you believe is best for you, including opting out of interventions, even for more significant tears, if that aligns with your values.

Tearing while currently a common part of birth, is not “Normal”. It is my prerogative to change the narratives we have created about birth.  Perineal damage is pathological and isn’t intended to occur in a healthy birth. I avoided tearing in both of my births and I believe with the right preparation and support you can too. 

From the BodyTalk perspective, tearing is not just a physical occurrence—it can also have deeper emotional, energetic, and spiritual meanings:

  • Release of Suppressed Emotions: Your body may experience tearing as a way to release old patterns, fears, or traumas stored in the tissues. These could be related to feelings of safety, security, or unresolved experiences from earlier in life.
  •  Releasing Stored Sexual or Generational Trauma: The perineum is part of the root chakra, closely connected to our most primal emotions and experiences, including those related to sexuality and birth. Tearing can signify a powerful release of stored sexual trauma or generational trauma related to birthing. This may involve letting go of unresolved pain from past experiences or inherited trauma patterns from previous generations, freeing you from what no longer serves you and allowing for a more liberated and conscious birth.
  • Boundaries and Vulnerability: The perineum represents a boundary between your internal and external worlds. Tearing could reflect weakened emotional or energetic boundaries or a fear of fully opening up to the birthing process.
  • A Call for Deeper Healing: Sometimes, tearing is an invitation to address emotional wounds or integrate parts of yourself that have been hidden or suppressed. It could be a message from your body, asking you to release what no longer serves you.

By understanding these metaphysical aspects, you can move towards deeper self-awareness and emotional healing. I can help you identify and release any stored emotions, fears, or trauma—whether personal or generational—creating a more holistic path to birth that honours your body and spirit.

Prenatal Preparation: Addressing Underlying Issues to Prevent Tearing

Before you enter the birth process, there are several ways you can consciously prepare your body, mind, and spirit to help prevent tearing:

1. Emotional and Energetic Clearing:

  •  Identify and Release Fear: Spend time reflecting on any fears or anxieties you have about birth, pain, or motherhood. Journaling, talking to a trusted support person, or working with a therapist can help. BodyTalk sessions can be particularly effective in pinpointing and clearing specific fears or traumas stored in the body, helping you feel more confident and prepared for birth.
  • Heal Past Traumas: Address any past traumas—whether related to your sexuality, body, or birth experiences—through therapeutic approaches that resonate with you. Healing these emotional wounds can help the body remain open and flexible during labor, reducing the likelihood of tearing.
  • Break Free from Generational Patterns: Reflect on any generational or familial beliefs around birth and motherhood that may not serve you. Consider your own birth into the world. Conscious practices, such as meditation or energy healing, can help release these inherited patterns, allowing you to create your own empowered birthing story. Not re-live past ones!

2. Physical Preparation for Flexibility and Relaxation:

  • Breathing into the Pelvic Floor: Instead of focusing solely on strengthening the pelvic floor, practice breathing into the pelvic area to encourage softness and relaxation. Deep, conscious breathing into the pelvic floor can help soften the tissues and create a sense of relaxation, which is essential for preventing tearing during birth.
  • Nutrition and Hydration: Eat a diet rich in vitamins (A, C, E) and collagen to support skin elasticity and tissue repair. Staying well-hydrated also ensures that your tissues remain supple and flexible.
  • Perineal Massage: While controversial, some find that this practice also brings awareness and connection to the perineum, helping you feel more in tune with your body’s needs. The research on the benefits of it is mixed.  If you calls to you work that area with love and reverence, openness and acceptance it can help to increase tissue elasticity and prepare the area for stretching during birth. But is in no way a necessity.  I did not practice this myself and had no perineal trauma. 

3. Mind-Body Techniques for Relaxation and Trust:

  • Meditation and Visualization: Use meditation and visualization techniques to imagine a smooth, tear-free birth. Focus on relaxing the perineum, trusting in your body’s capacity to birth naturally and gently.
  • Breathwork and Body Awareness: Practice deep, conscious breathing exercises that help you connect with your body’s rhythms and cultivate a sense of calm and trust in your body’s wisdom. This helps you relax during labor and reduces tension in the pelvic floor.
  • Affirmations for Empowerment: Use affirmations like, “My body is strong and capable,” or “I trust in my body’s ability to birth gently,” to reprogram your mind and create a positive mindset around birth. Our thoughts do create our reality! 

Prenatal BodyTalk sessions can assist in releasing unresolved emotions or trauma, strengthening your body’s readiness for birth, and aligning your conscious and subconscious minds for a smooth birthing experience. By working on these underlying issues, you help prepare your body at all levels to prevent tearing.

Creating a Self-Led, Intervention-Free Birth Experience

In addition to prenatal preparation, the way you approach birth can significantly impact whether tearing occurs. Here’s how you can take charge:

1. Avoiding Unnecessary Interventions: You have the right to refuse interventions, such as episiotomies, which can increase the risk of tearing. You can forgo cervical exams and keep the peace and ease in your yoni. Trust your body’s natural ability to birth without external interference. Natural tears are known to heal better than episotomy cuts as the ragged edges have distinct surface area to realign with.

2. Choosing Optimal Birth Positions: Positions like ‘knees in, heels out’ help open your sit bones and create more space for your baby to emerge. Other positions like squatting, all-fours, lunge or side-lying can reduce pressure on the perineum. Being on your back is typically the worst for tearing. 

3. Waiting Until You Feel the Urge to Push: Respect your body’s natural rhythms. Waiting until you have an uncontrollable urge to push allows you to work with the fetal ejection reflex, helping your baby emerge smoothly without forcing or rushing.

4. Allowing Time for Proper Fetal Rotation: Patience is key; giving your baby time to rotate correctly, especially their shoulders, can reduce pressure on the perineum and minimize the risk of tearing.

By working with your body’s natural instincts and rhythms, you can create a more supportive environment for a gentle birth experience.

If Tearing Happens

If tearing does occur, know that you have options. The medical consensus typically recommends suturing for significant tears (second-degree and above) to promote proper healing and prevent complications, but you are free to choose the path that feels right for you, even if that means opting out of suturing. In the free-birth world there are many stories of severe tears healing perfectly on their own with proper rest. 

Understand the Pros and Cons of Suturing:

  •  Pros: Suturing can promote proper alignment of tissues, help control bleeding, and reduce the risk of infection for more significant tears.
  • Cons: Potential downsides include scar tissue that may reduce flexibility, increased pain or discomfort, risk of infection, and even emotional trauma if the procedure is done without adequate consent or anesthesia. Or stitched too tightly, the extra ‘husband stitch’ to make you ‘tighter’ is considered harmful and unethical and unfortunately can happen without consent. 
  • Your Right to Choose: It’s important to know that you can choose to avoid suturing if that feels right for you, even in the case of more severe tears.Trust your body’s wisdom and your intuition about what’s best for you.

If suturing is necessary or if you choose it, I can help address any emotional trauma, clear energetic disturbances, and support faster, more comfortable healing with scar work through BodyTalk.

Natural Healing Methods

For minor tears, or if you prefer a natural approach, there are several options to support your body’s natural healing:

1. Rest and Positioning:

   – Keep your legs closed and prioritize extended bed rest (at least two weeks) to help maintain tissue alignment. Gradually return to activities to prevent re-injury.

2. Seaweed Patches:

   – Some midwives use seaweed patches instead of sutures. The seaweed is moistened with sterile water and placed along the tear to hold the edges together, promoting natural healing.

3. Manuka Honey:

   – Apply Manuka honey topically to prevent infection and support tissue regeneration. Its antimicrobial properties make it a wonderful natural remedy for perineal tears.

4. Herbal Remedies:

   – Herbs like comfrey, yarrow, sage, rosemary, calendula, and chamomile can reduce inflammation and support healing. Use them in sitz baths or perineal sprays to soothe the area.

5. Homeopathic Remedies:

   – Arnica can help with pain, swelling, and bruising. Consider using it to support your healing journey.

6. Medical Adhesive (or SuperGlue):

   – For minor tears, some healthcare providers might use medical-grade adhesive as an alternative to suturing. This can be less painful, quicker, and may reduce the risk of infection compared to traditional stitches.

Ultimately, the decision on how to manage perineal tearing—if it occurs—rests with you. This is your birth, your body**, and your experience. Whether you choose natural healing, minimal intervention, or decide to opt for medical repair, trust that you know what’s best for you.

If you are looking to prevent tearing, or want to explore all your options for managing it, connect with  specialized practitioners like me, who respects your choices, honors your body’s wisdom, and supports your decisions. Joanne can help you navigate both the physical and emotional aspects of birth, ensuring a holistic and empowering experience.

You deserve a birth experience that feels aligned, empowered, and respectful of your body’s natural abilities. Your journey to birth is unique, and you have the right to make it exactly as you envision. Remember, this is your time, your body, and your beautiful birthing experience.

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