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8. Take advantage of pain management techniques – There are plenty of techniques that can help you manage pain without the use of drugs. Consider using some or all of these:

Water therapy Massage Acupressure Birthing ball Relaxation/meditation/hypnosis Move around, walk, pace, squat, rock, sway, dance Warm compresses Breathing techniques Essential oils/aromatherapy Music Nitrous oxide

In conclusion, natural birth has many rewards. Most women can do it if they choose to. However, birth can be unpredictable and pain relief and cesarean sections are sometimes necessary. : 8 ways to prepare for natural birth: Easing labor pain without an epidural

Is there a way to give birth without pain?

Benefits of an epidural birth – The biggest benefit of an epidural is undoubtedly pain relief during labor and through delivery. After the 10 to 20 minutes needed for an epidural to take effect, many individuals find that an epidural provides them with an easier, less stressful birth experience. Other benefits of giving birth with an epidural can include:

Flexible pain relief – If you use an epidural for labor, the dosage and resulting numbness can be increased or decreased depending on how much relief you need. This can include being able to control your medication pump with the push of a button. Non-drowsy pain relief – Many individuals choose an epidural because it relieves their pain and relaxes them, while still allowing them to stay awake and alert during labor and delivery. A backup plan – If you’ve planned for a natural birth, but the pain gets to be too much, you can still choose to get an epidural or other pain medication if you’re giving birth at a hospital-based birth center. If you’ve chosen a freestanding birth center for your delivery, epidurals are typically not an option. So, you would need to be transferred to a local hospital if you change your mind.

How can I control my pain during normal delivery?

Epidural anaesthesia – Epidural injections are the most effective pain relief available. They are used for vaginal births and also for caesarean sections, because they allow the mother to stay awake and alert during the baby’s birth. Anaesthetic is injected into the lining of the spinal cord through the back, which makes the mother feel numb from the waist down.

The anaesthesia may not be complete and you may still experience some pain. This may require the procedure to be repeated. After the epidural has been inserted, your blood pressure may drop, causing you to feel faint and nauseated. This may also cause stress to your baby. This is treated by giving intravenous fluid. An epidural often causes some muscle weakness in the legs, so women who have had an epidural anaesthetic may be confined to bed. The lack of sensation in the lower body means that you will not be able to tell when you need to urinate. A urinary catheter will be inserted in most cases. Epidurals can lengthen the second stage of labour. The likelihood of having a normal vaginal delivery is reduced. If you are unable to push effectively, due to altered sensation and reduced muscle strength, the baby may have to be delivered by forceps or vacuum cup. Around one per cent of women experience headache immediately following the procedure. Some women experience itchiness after having an epidural. This can usually be effectively treated using antihistamines. Some women experience pain or tenderness where the epidural was injected. Around one in 550 women experience ongoing patches of numbness on the back near the injection site. Very rare complications include infection, blood clots and difficulty breathing.

An epidural does not:

increase the length of the first stage of labour increase the likelihood of a cause long-term backache.

Which week is best for normal delivery?

Why at least 39 weeks is best for your baby Are you thinking about scheduling your baby’s birth? Scheduling your baby’s birth means you and your health care provider decide when to have your baby by or instead of waiting for labor to begin on its own.

• Depending on your health and your baby’s health, scheduling your baby’s birth may be best.
• But scheduling birth a little early for non-medical reasons can cause problems for you and baby.
• If your pregnancy is healthy, it’s best to stay pregnant for at least 39 weeks and wait for labor to begin on its own.

When you schedule your baby’s birth, you schedule either labor induction or a c-section. Labor induction (also called ) is when your provider gives you medicine or breaks your water (also called amniotic sac) to make your labor begin for vaginal birth.

1. Vaginal birth is when the muscles of your uterus contract (get tight and then relax) to help push your baby out through the vagina (also called birth canal).
2. Most babies are born by vaginal birth.
3. A cesarean birth (also called ) is surgery in which your baby is born through a cut that your provider makes in your belly and uterus.

You may not have a choice about when to have your baby. If there are problems with your pregnancy or your baby’s health, you may need to have your baby early. But if you have a choice and you’re planning to schedule your baby’s birth, wait until at least 39 weeks.

Important organs, like your baby’s brain, lungs and liver, need time to develop. The brain develops fastest at the end of pregnancy. A baby’s brain at 35 weeks of pregnancy weighs only two-thirds of what it will weigh at 39 to 40 weeks. He’s less likely to have health problems after birth, like breathing, vision and hearing problems. He can gain more weight in the womb. Babies born at a healthy weight have an easier time staying warm than babies born too small. He can suck and swallow and stay awake long enough to eat after he’s born. Babies born early sometimes can’t do these things. He’s less likely to have learning problems and health problems later in life than babies born before 39 weeks.

Can scheduling an early birth cause problems for you and your baby? Yes. Sometimes it’s hard to know exactly when you got pregnant. Even with an, your can be off by as much as 2 weeks. If you schedule an induction or c-section and your date is off by a week or 2, your baby may be born too early.

Stronger and more frequent contractions. Frequent contractions may cause changes in your baby’s heart rate. Infection for you and your baby Uterine rupture. This is when the uterus tears during labor. It happens very rarely. Needing a c-section. If your labor is induced and the medicine doesn’t start your labor, you may need to have a c-section.

Problems from a c-section

Breathing and other medical problems for your baby. Babies born by c-section may have more breathing and other medical problems than babies born by vaginal birth. Needing a c-section in another pregnancy. Once you have a c-section, you may be more likely in future pregnancies to have a c-section. The more c-sections you have, the more problems you and your baby may have, including, Longer recovery for mom. A c-section is major surgery. It takes longer for you to recover from a c-section than from a vaginal birth. You can expect to spend 2 to 4 days in the hospital after a c-section. Then you need about 6 to 8 weeks after you go home to fully recover. You also may have complications from the surgery, like infections, bleeding or, So it’s important to stay in touch with your health care provider even after you go home.

What questions can you ask your health care provider about scheduling your baby’s birth? If you’re planning to schedule your baby’s birth, print out this article and take it with you to your next, Ask these questions: If your provider recommends that you have your baby before 39 weeks

Is there a problem with my health or the health of my baby that makes birth before 39 weeks necessary? Can I wait to have my baby until I’m closer to 39 weeks?

About inducing labor

Why do you need to induce labor? How will you induce my labor? What can I expect when you induce labor? Will inducing labor increase the chance that I’ll need to have a c-section?

About having a c-section

Why do I need to have a c-section? What can I expect during and after a c-section? What problems can a c-section cause for me and my baby? Can I have a vaginal birth in future pregnancies?

See also: Last reviewed: October, 2018 : Why at least 39 weeks is best for your baby

How painful is labor?

While labor and delivery are expected to be painful, there are many ways to manage the pain. Labor pains vary from woman to woman and even one pregnancy to the next. Pain during labor is described as extreme menstrual cramps, strong cramping, severe pressure, extremely strong waves similar to diarrhea cramps, bad back pain, an achy feeling, and a broken bone.

• Labor and delivery are painful, but it’s a manageable pain.
• A survey by the American Society of Anesthesiologists (ASA) found that 46% of first-time mothers said labor and delivery pains they experienced with their first child were better than they expected.
• Ninety percent of women said pain management during labor and delivery was effective, no matter what method they chose.

Women experience pain during labor and delivery differently, and it can also vary in the same woman for each pregnancy, Pain during labor is caused by contractions of the muscles of the uterus and by pressure on the cervix which can be described as:

Extreme menstrual cramps Strong cramping in the abdomen, groin, back, sides, and even thighs Severe pressure Extremely strong waves that feel like diarrhea cramps Bad back pain An achy feeling A broken bone

Most women find the most painful part of labor and delivery to be the contractions, while some others may feel pushing or post-delivery is most painful. Pain during labor and delivery may also be caused by pressure on the bladder and bowels by the baby’s head and the stretching of the birth canal and vagina.

• Sometimes, it’s not the pain of contractions that is most difficult, but the fact that they don’t stop and as labor continues, there is less time between contractions to relax.
• Being proactive in pain management is important, which can mean choosing an epidural right away or using other medical or alternative pain management techniques.

Expectant mothers can talk to their obstetricians and anesthesiologists about pain management methods. It is a good idea to have a birth plan to make sure your preferences are clearly outlined. Things to consider regarding pain control during labor:

Medications may significantly reduce pain, but probably won’t relieve all of it Labor may hurt more than expected and sometimes women who wanted no pain medicine change their minds when in labor Some medicines can affect the baby, causing drowsiness or changes in the heart rate

Many expectant mothers use a combination of methods. Pain management during labor and delivery may include:

Medical

Epidural (most common option)

A form of local anesthesia that delivers medicines through a catheter inserted into the mother’s back An advantage is that very little medicine reaches the baby, so there are few to no effects on the baby

Medication delivered through an IV or injection

Analgesics for pain Regional anesthesia Tranquilizers to calm and relax anxious mothers

Spinal block Nitrous oxide (rarely used)

Complementary methods

Breathing Water birth Massage or counterpressure Hypnosis Yoga Meditation Walking Changing position Taking a bath or shower Listening to music Distracting yourself by counting or performing an activity that keeps your mind otherwise occupied

Before delivery, there are some things a mom-to-be can do to prepare for birth and help with pain during labor:

Exercise regularly to help strengthen muscles, increase endurance, and prepare the body for the stress of labor

Consult your doctor to learn about exercise that is appropriate and safe

Childbirth classes

These teach different techniques for handling pain, from visualization to stretches designed to strengthen the muscles that support the uterus Lamaze technique

Most widely used method in the United States Teaches women ways they can decrease their perception of pain, through relaxation techniques, breathing exercises, distraction, or massage by a supportive coach This technique takes a neutral position toward pain medicine, encouraging women to make an informed decision about what is right for them

Bradley method (also called Husband-Coached Birth)

Emphasizes the active participation of the baby’s father as birth coach A goal of this method is to avoid use of medications unless absolutely necessary Focuses on proper nutrition and exercise during pregnancy and relaxation and deep-breathing techniques as a method of coping with labor

References https://www.asahq.org/about-asa/newsroom/news-releases/2018/05/pain-of-labor-and-delivery https://kidshealth.org/en/parents/childbirth-pain.html

How can I push during labor without tearing?

Can vaginal tears during childbirth be prevented? – Answer From Yvonne Butler Tobah, M.D. Vaginal tears during childbirth, also called perineal lacerations or tears, occur when the baby’s head is coming through the vaginal opening and it is either too large for the vagina to stretch around or it is a normal size but the vagina doesn’t stretch easily.

• Prepare to push. During the second stage of labor, the pushing stage, aim for more controlled and less expulsive pushing. Pushing the baby out gently and slowly can allow your tissue time to stretch and give way for the baby. Your health care provider will offer guidance.
• Keep your perineum warm. Placing a warm cloth on the perineum during the second stage of labor might help.
• Perineal massage. During the second stage of labor, your health care provider might place two fingers of a lubricated gloved hand just inside your vagina and move them from side to side, exerting mild, downward pressure. Your health care provider might also recommend perineal massage at home at the end of your third trimester, before the start of labor. You can do this yourself or with the help of your partner.
• Deliver in an upright, nonflat position. There are a number of delivery positions that might reduce the risk of a vaginal tear during childbirth. Rather than lying down flat during delivery, deliver in an upright position. Your health care provider will help you find a comfortable and safe delivery position.

If you’re concerned about vaginal tears during childbirth, talk to your health care provider. Ask what techniques he or she uses to prevent vaginal tears and for any additional advice to help you prepare for delivery. With Yvonne Butler Tobah, M.D.

How can I feel if my cervix is open?

Your cervix changes position many times throughout your menstrual cycle, For example, it may rise alongside ovulation to prepare for conception or lower to allow menstrual tissue to pass through the vagina. Each change in position is tied to a particular phase in your menstrual cycle or other hormonal change, such as pregnancy.

1. Checking the position and texture of your cervix — as well as any cervical mucus — can help you gauge where you are in your cycle.
2. You may find this information especially useful if you’re tracking your ovulation or trying to conceive.
3. Your cervix is pretty deep inside your body.
4. It acts as a canal connecting the lower part of your uterus to your vagina.

Doctors typically insert special instruments, such as a speculum, into your vagina to access the cervix. Although you can safely use your fingers to try this at home, it isn’t always easy to feel or locate your cervix. There are a number of reasons why you may not be able to, and none of them are cause for concern.

you may have a long vaginal canal, making it difficult to reach the cervixyou may be ovulating, so your cervix is higher than usualyour cervix may settle into a higher position during pregnancy

You may be able to locate your cervix using the following steps: 1. Empty your bladder before you begin. A full bladder can elevate your cervix, making it harder to find and feel.2. Wash your hands thoroughly with warm water and antibacterial soap. If you don’t, you may push bacteria from your fingers or vaginal canal deeper into your body.3.

1. Position yourself so you have the most comfortable access to your cervix.
2. Some people find that standing with one foot elevated, such as on a stepstool, provides easier access.
3. Others prefer squatting.4.
4. If you want to actually see your cervix, place a mirror on the floor underneath your pelvis.
5. You may have to use your nondominant hand to separate your labia for easier visualization.

Pro-TIP Before moving on to step five, you may find it helpful to apply lubricant to the fingers you plan to insert. This will allow your fingers to slide in without friction or related discomfort.5. Insert the index or middle finger (or both) on your dominant hand into your vagina.

1. Note the way your skin changes texture as you move closer toward your cervix.
2. The vaginal canal usually has a softer, spongy-type feel.
3. The cervix is usually firmer and may feel more smooth.
4. That said, this texture can vary based on where you are in your menstrual cycle.
5. There are lots of analogies for how the cervix feels, from the “tip of your nose” to your “lips puckered in a kiss.” 6.

Feel in the middle of your cervix for a slight dent or opening. Doctors call this the cervical os. Note your cervical texture and if your cervix feels slightly open or closed. These changes can indicate where you are in your menstrual cycle.7. You may find it helpful to record your observations.

1. You can write them down in a dedicated journal or record them on an app, such at the Kindara: Fertility Tracker,
2. Although this app is primarily a fertility tracker, it allows you to log cervical changes.
3. Alternative approach You can also purchase a self-exam kit from the Beautiful Cervix Project that contains a reusable speculum, mirror, flashlight, and additional instructions.

This site also has actual pictures of the cervix at various points throughout the average cycle.

What can I drink to deliver faster?

Anecdotal evidence suggests that exercise, sex, and eating certain foods may help move labor along. But it’s best to talk with a healthcare professional before attempting to induce labor. Your due date is an educated guess for when your baby might make its arrival.

1. While many women deliver perfectly healthy babies 2 weeks before or after this presumed due date, it’s recommended that women wait until at least 39 weeks for delivery.
2. It’s best to let mother nature decide when your baby comes.
3. In a 2011 study, 201 women who had recently delivered babies were surveyed about inducing labor at home.

Of these women, 50 percent had tried a natural method of getting labor started. If you’re 40 weeks in, here are seven natural ways to get things moving along. Most of these methods are anecdotal and don’t have solid evidence that they work, so you should always talk to your healthcare provider before attempting any of these methods.

Your midwife or doctor may not be able to confirm that they work, but they can let you know if it’s safe to try with your pregnancy. Exercise can be anything that gets the heart rate up, such as a long walk. Even if this method doesn’t work, it’s a great way to relieve stress and keep your body strong for the task ahead.

Theoretically, there are multiple reasons why having sex could induce labor. For example, sexual activity, especially having an orgasm, can release oxytocin, which may help jumpstart uterine contractions, Also, for pregnant people who have sex with men, there are prostaglandin hormones in semen that might help ripen the cervix.

Having sex is safe during the final weeks of pregnancy, but you shouldn’t have sex after your water has broken. Doing so can increase your risk for infection. Stimulating your nipples can cause your uterus to contract and may bring about labor. Nipple stimulations stimulate oxytocin production. Oxytocin is the hormone that causes the uterus to contract and the breast to eject milk.

In fact, if you choose to breastfeed your baby right after delivery, this same stimulation is what will help your uterus shrink back to its original size. You or your partner may manually stimulate your nipples, or you can try using a breast pump. Solid research shows that breast stimulation can be an effective way to:

induce and augment labor avoid a medical inductionreduce rates of postpartum hemorrhage

Acupuncture has been used for thousands of years. The exact way that acupuncture works is unclear. In Chinese Medicine, it’s believed that it balances the chi or vital energy within the body. It might also stimulate changes in hormones or in the nervous system.

Acupuncture should be administered only by a licensed acupuncturist. In a 2013 randomized trial in Denmark, more than 400 women were given acupuncture, membrane stripping, or both procedures before labor. Study results showed that acupuncture didn’t decrease the need for induction, but sweeping membranes did.

According to research, the main benefit of acupuncture is increased cervical ripening. Some practitioners believe that acupressure can help start labor. Prior to applying acupressure to yourself, make sure you get proper instruction from a trained acupressure professional.

1. If acupressure doesn’t get your labor going, it can still be an excellent way to alleviate pain and discomfort during labor.
2. Drinking a little bit, like only 1–2 ounces (29.57–59.14 mL) of castor oil stimulates prostaglandin release, which can help ripen the cervix and get labor started.
3. It’s recommended that this be done under the supervision of a midwife or doctor.

People should be careful not to drink too much. Some research shows that eating dates in the final weeks of pregnancy

increases cervical ripening and cervical dilation at the start of labor decreases the need for Pitocin use during labor

Most pregnant people at 40 weeks are likely ready to have their babies out of their bellies as soon as possible and in their arms. However, there are plenty of perks to waiting until your body naturally decides to go into labor — including recovery. Women who weren’t induced typically recover more quickly than those who were.

more time to build muscle and strengthreduced risk of low blood sugar, infection, and jaundice improved breathing as infants born even as little as two weeks early can experience twice the number of complicationsbetter feeding once bornincreased brain development, with the brain growing a third of its size between weeks 35 and 40

Let your body do the work for a few more days and take the time to get as much rest as you possibly can. We know, that’s easier said than done when you’re 9 months pregnant. You and your baby will need all your energy soon enough! Before trying anything that might induce labor, speak with your healthcare provider to go over any risks or possible complications.

What not to eat before labor?

What should I eat before labor induction? – The best foods for labor are easy to eat and digest, filling, and energizing. That also means avoiding foods that are high in fat, greasy, or spicy, since these can be more difficult to digest. Here are key nutrients to consider before contractions hit:

Carbohydrates: Energizes your labor so you can push through like a champ. Protein: Keeps you satisfied and sustained for a hunger-free labor. Low fat: Sticking to low-fat foods may help reduce the risk of laboring with stomach discomfort. Low fiber: While fiber is great for your health, it can be hard on your digestive system when your body is otherwise working hard during labor. So in this case, low fiber is the way to go.

Can I open my cervix with my fingers?

1. Mechanical cervical ripening – To say that we are mechanically ripening the cervix means that we are forcibly dilating it. A Foley catheter is typically used to drain urine from the bladder. The tip of the catheter has a balloon, which holds about 2 TBSP of water.

If we place the tip of the Foley into the cervix and inflate the balloon, the balloon will push the cervix open over time. Protocols vary, and the bulb will either be left inside the cervix for at least 12 hours or until it falls out. The cervix can also be dilated just by an examination by your provider.

The finger can gently dilate the cervix and separate the membranes from the uterine wall. This is called “membrane stripping.” It may be uncomfortable for the patient, but it can be effective.

Why cervix is not opening?

Female reproductive system – The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system. An incompetent cervix happens when weak cervical tissue causes or plays a part in a premature birth or the loss of a healthy pregnancy. An incompetent cervix also is called cervical insufficiency.

The cervix is the lower part of the uterus that opens to the vagina. Before pregnancy, it’s usually closed and firm. As pregnancy goes on and you get ready to give birth, the cervix slowly changes. It softens, gets shorter and opens. If you have an incompetent cervix, it might begin to open too soon causing you to give birth too early.

An incompetent cervix can be a hard problem to diagnose and treat. If your cervix begins to open early, or if you’ve had cervical insufficiency in the past, you might benefit from treatment. This might include having a procedure done to close the cervix with strong sutures, called a cervical cerclage.

What triggers labor to start?

THE SIX CARE PRACTICES THAT SUPPORT NORMAL BIRTH – Care Practice #1: Labor Begins on Its Own Key Points

Labor normally begins when both your body and your baby are ready. Induction of labor doubles your chance of having a cesarean section. Carrying a big baby is not a medical reason to induce labor. Letting labor begin on its own means you are more likely to experience the other care practices that support normal birth.

It is important to know that “postterm” means you are 2 weeks past your due date. All obstetric associations define a normal pregnancy as lasting anywhere from 38 to 42 weeks. The expert physicians who write the leading obstetric textbook, Williams Obstetrics ( Cunningham et al., 2005 ), have a policy of following closely women whose pregnancies have reached 41 weeks.

• But they do not induce until the pregnancy reaches 42 completed weeks unless there is another medical reason to do so.
• They say that inducing at 41 (rather than 42) weeks would mean that about 500,000 more women each year would use interventions that have not been conclusively proved necessary or harmless.

It is also important to know that suspecting a large or very large baby is not a medical reason for induction. Studies have shown that inducing labor for macrosomia (large baby) almost doubles the risk of having cesarean surgery without improving the outcome for the baby ( Horrigan, 2001 ; Leaphart, Meyer, & Capeless, 1997 ; Sanchez-Ramos, Bernstein, & Kaunitz, 2002 ).

What is the most painless delivery?

Painless Normal Delivery Expecting a baby is one of the most memorable journeys of a woman’s life. The physical and hormonal changes that come along with it are unique. If you are pregnant, it is obvious for you to worry about labor& the pain you are going to face during the labor process.

Modern medicine has brought about some revolutionary advancement that reduces the pain during childbirth to an acceptable level. This technique of normal delivery is known as Epidural Analgesia or painless normal delivery. What is Painless Normal Delivery? Painless normal delivery or delivery with labor analgesia (Epidural) is a technique where very specific concentration of drug is used.

Although the drug reduces the pain, it maintains the ability to push your baby out through the birth canal. A needle and a very thin plastic tube (epidural catheter) are involved in this technique.The drug to reduce your pain is continuously administrated through this tube with the help of aninfusion pump.The primary aim of the epidural is to reduce the pain of contractions to an acceptable level.

Less postpartum complications: By alleviating pain, it allows the mother to focus on the delivery. It is an aid for relaxation and can prevent exhaustion and irritation experienced by most women during childbirth, thereby reducing the risk of developing postpartum complications. Relaxes the muscles while delivery: Epidural analgesiahelpsthe baby descend easily by relaxing the pelvic and vaginal muscles. Lowers blood pressure of the mother : It also helps in lowering the blood pressure of the mother, which otherwise can rise to dangerous levels during labour. Beneficial for mothers with cardiac complications: Heavy pain may affect those mothers who have a history of cardiac complications or who are experiencing heart problem. In such cases, the painless delivery will be favourable. Less secretion of stress hormones: Due to the excessive torment and pain, the mother secrets more stress hormones which cause a great deal of irritation and distress to the child as well as the mother. Since, Epidural analgesiareduces the pain and torment, the amount of hormones produced will be very less and hence,both mother and child can be comfortable. Comfortable delivery option for elderly mothers (more than 30 years): The threshold of bearing pain decreases with aging. Hence, elderly mothers can take the advantage of normal child delivery with epidural analgesia or the painless delivery option.

How long does an epidural analgesialast ? The epidural analgesia lasts for as long as the catheter is in place and the woman receives the medication through it. However, a woman stops receiving the medication once her baby is delivered and the catheter is removed.

Choose a hospital or birth centre where epidural analgesia is available Beware of the type of pain relief that suits you the best Inform your doctor about allergic reactions, if any

NeotiaGetwel Healthcare Centre in Siliguri has a comprehensive Department performing Painless Normal Delivery by experienced Obstetricians & Gynaecologists, Anaesthesiologist and support team on board backed by Modern Delivery Room, Multidisciplinary team approach for high risk pregnancy, emergency delivery& other pregnancy related complication management, well baby nursery, antenatal consultation, level III NICU, 24 x 7 presence of Obstetrician & Gynaecologist, 24 x 7 presence of Neonatologist, Paediatric Surgeon & Sub Specialists.

Is it possible to give birth naturally without tearing?

Can vaginal tears during childbirth be prevented? – Answer From Yvonne Butler Tobah, M.D. Vaginal tears during childbirth, also called perineal lacerations or tears, occur when the baby’s head is coming through the vaginal opening and it is either too large for the vagina to stretch around or it is a normal size but the vagina doesn’t stretch easily.

• Prepare to push. During the second stage of labor, the pushing stage, aim for more controlled and less expulsive pushing. Pushing the baby out gently and slowly can allow your tissue time to stretch and give way for the baby. Your health care provider will offer guidance.
• Keep your perineum warm. Placing a warm cloth on the perineum during the second stage of labor might help.
• Perineal massage. During the second stage of labor, your health care provider might place two fingers of a lubricated gloved hand just inside your vagina and move them from side to side, exerting mild, downward pressure. Your health care provider might also recommend perineal massage at home at the end of your third trimester, before the start of labor. You can do this yourself or with the help of your partner.
• Deliver in an upright, nonflat position. There are a number of delivery positions that might reduce the risk of a vaginal tear during childbirth. Rather than lying down flat during delivery, deliver in an upright position. Your health care provider will help you find a comfortable and safe delivery position.

If you’re concerned about vaginal tears during childbirth, talk to your health care provider. Ask what techniques he or she uses to prevent vaginal tears and for any additional advice to help you prepare for delivery. With Yvonne Butler Tobah, M.D.