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9 Exercises to Prevent Tearing During Birth

Tearing during birth may be common, but it’s not unavoidable. Nine exercises can help you prevent tearing during birth. Learn about each, plus the #1 thing that can help you avoid tearing.

pregnant woman sitting cross-legged which is one of the exercises that can help prevent tearing during birth

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In today’s world, birth is all about choices. And often, the more you know, the better your experience will be. Clearly, you being here means you are trying to learn all you can.

In the learning you’ve done up to this point, you’ve probably heard that some women tear while giving birth.

It is common but the good news it usually isn’t serious. The best news is that you can do a LOT to prevent tearing during birth, both during pregnancy and during birth itself.

I’ve already written about perineal tearing and how to avoid it. Today I want to address one specific element of avoiding tears: exercise.

A Word on Perineal Massage

First, let’s talk about one common piece of advice that may not be all that it seems: perineal massage.

If you’ve asked around or searched online, you’ve probably heard the advice to do perineal massages during the last few weeks of pregnancy.

I heard it too. And I wanted to know what the research said.

Here’s what I found.

In a nutshell, perineal massage during pregnancy isn’t harmful but it also doesn’t provide that much benefit.

To go into a little more detail, researchers have found a few things consistently.

First, perineal massage only helps first-time moms. Mothers who have given birth before see no benefit from doing it.

Second, the benefit to first-time moms was only seen in studies that looked at birth settings with extremely high episiotomy rates.

In the US (as of 2023), average episiotomy rates in hospitals are about 5%. The studies that found benefits from perineal massage were in places that had episiotomy rates over 20%. That difference makes it hard to draw real comparisons or to generalize those findings.

But how are episiotomies connected to perineal massage?

Most likely, the connection is the mother. In other words, the kind of woman who does perineal massage is more likely to make other choices that protect her perineum.

The Best Thing You Can Do to Avoid Perineal Tearing

What the researchers and other professionals have concluded is that women who are motivated to maintain an “intact perineum” (the medical term for not tearing or getting an episiotomy) are probably more likely to refuse an episiotomy.

They are probably also more likely to carefully choose a care provider who has a low or non-existent episiotomy rate.

Some doctors and hospitals have low episiotomy rates. That’s great. But some still regularly perform episiotomies, sometimes without even asking the mother before doing so.

Why is it important to avoid episiotomies? Because episiotomies are the leading cause of severe perineal tears. 

That is why getting to know your care provider and choosing them and your birth place carefully is the best thing you can do to avoid perineal tearing during birth.

So the time you could spend doing perineal massage is probably better spent choosing a great care provider and making sure you’re on the same page about birth.

How Does Exercise Prevent Tearing During Birth?

With those things established, let’s talk about exercise. First, how can exercise reduce your risk of tearing?

Exercise does three things to help get your perineum ready for birth. Exercise can…

  1. Stretch and relax your pelvic floor, 
  2. Strengthen your pelvic floor and legs to protect your perineum, and 
  3. Help your baby get and stay in a good position for birth.

Obviously, a perineum that is relaxed and flexible will have an easier time letting a baby through without tearing.

Strengthening the muscles surrounding your pelvis can help you have more control over the speed of your baby’s birth, which can help reduce your risk of tearing.

Your baby’s position plays a role in preventing tearing because if he or she is turned in an un-ideal way, a wider portion of their head may be born first, forcing your perineum to stretch more than it wants to.

What Exercises Can Prevent Tearing During Birth?

Now let’s get to the meat of it. What exercises can you do during pregnancy to prevent tearing during birth? Not including perineal massage (for the reasons I gave above), there are 9 exercises you can do regularly to get your perineum ready for labor.

Most of these exercises are actually stretches, not intense movement.

Let’s go over each one and how it can help prevent tearing.

Child’s Pose

First, we’ll start with a simple yoga pose: child’s pose.

To do child’s pose, start by kneeling – toes touching and knees apart – and sinking your hips back towards your heels. Extend your arms forward, palms down, letting your forehead rest gently on the mat. Breathe deeply and slowly and let every muscle relax.

Child’s pose is great for two reasons.

First, it stretches your pelvic floor and other surrounding muscles, helping them become more flexible and ready to open for your baby’s head.

Second, it’s a great way to relax. At the end of pregnancy, you can support your belly and/or upper body with a pillow so the weight doesn’t put too much pressure on your back. Then play with the width of your knees until you find the most comfortable position.

You should be able to let all the tension go, relaxing not only your pelvic area but your upper body and your mind as well.

Deep Squats

Next, let’s talk about deep squats. By “deep” I mean you’re almost sitting on the floor you’re so low. 

To do a deep squat, start by standing with your feet hip-width apart or slightly wider and your toes turned out, like 10 and 2 on a clock. Slowly lower your body down as if you’re about to sit in a really short chair, keeping your weight in your heels and your back straight.

Extend your arms forward for counterbalance if you need to.

Go as low as you can. If you fall over, you can modify your squat by lifting your heels off the floor or by putting a yoga block or rolled up blanket under your backside as support.

Deep squats help prevent tearing during birth in a few ways.

First, like child’s pose, they stretch your pelvic floor and the surrounding muscles. The depth of your squat gives your glutes lots of room to lengthen out.

Deep squats can also help to relax your pelvic area and your lower back. You may not feel the relaxation at first – it can be hard to get comfortable in such a deep squat. But as you practice regularly, the right muscles will get stronger and others will get more flexible, allowing you to be more comfortable in the squat. 

Finally, squats can build strength and stability in your legs and your core, both of which will support you in other exercises and during labor.

Kneeling Runner’s Lunge

Next up: a runner’s lunge. This movement engages multiple muscle groups while also helping with flexibility and strength, both of which are important for birth.

To do a runner’s lunge, start in a kneeling position with your knees hip-width apart. Take a step forward with one foot, making a 90° angle with your front knee. Your back knee can form a 90° angle or more.

Place your hands on the ground on either side of your front foot. Hold this position for a few breaths, feeling the stretch in your hips and thighs.

If you feel able and want more stretch and work in your muscles, you can lift your back knee of the floor and lengthen your back leg. Keep your back leg and your spine in a straight line.

If your belly gets in the way, move your front foot out a little to make more room.

Runner’s lunge offers several benefits for preparing the perineum for childbirth.

First, it stretches the muscles in the pelvic floor and hips, which increases flexibility. Flexibility is important during birth because your pelvis has to open and shift slightly to allow your baby to come through.

Runner’s lunge also strengthens the muscles surrounding your pelvis which can help you feel more stable and supported during labor and birth.

Finally, runner’s lunge can encourage relaxation and focus and provide an opportunity to practice good breathing. As you hold the stretch, focus on deep breathing and let go of any tension or stress you may be holding in your body.

Alternative: Knees to Chest

As an alternative to runner’s lunge, you can do a lying knees-to-chest stretch.

Lie on one side, supporting your head in your hand, propped up on your elbow. Pull your top leg up toward your chest, grabbing the back of your thigh or the front of your shin with your hand. Hold for a few breaths then repeat on the other side.

A knees-to-chest stretch should help you relax similar areas but it may be more accessible to you, especially if you are nearing the end of your pregnancy.

Butterfly Stretch

The next exercise that can help prevent tearing during birth is the butterfly stretch. Depending on your flexibility, it may feel like a more gentle stretch or it might feel more intense.

To do the butterfly stretch, sit on the floor with your knees bent and the soles of your feet together. Hold onto your feet or ankles with your hands, and gently press your knees towards the ground. You should feel a stretch along your inner thighs and groin area.

Hold this position for a few breaths, allowing your muscles to relax and lengthen more with each breath.

The butterfly stretch, like the others mentioned, helps with flexibility and relaxation. 

Tailor Sitting

“Tailor sitting” is just sitting cross-legged, ideally on the floor. The benefits of tailor sitting are similar to those of the butterfly stretch. It helps to lengthen the muscles of your upper legs, as well as those in your back and pelvis.

Tailor sitting also encourages good circulation, which is important because your blood carries oxygen and nutrients to your baby. Good circulation is also important because it helps you avoid swelling and varicose veins.

Another benefit of tailor sitting is that it tips your pelvis forward, which keeps your uterus in alignment and makes it more likely that your baby will be in a good position for birth.

Kegels

Kegels may seem a little counterintuitive if you’re thinking about how you need to be relaxed during birth. But kegels are important for a safe birth for a few reasons. 

First, the pelvic floor is what your baby’s head slides across as he or she makes their way through the birth canal. If your pelvic floor is toned (rather than loose) your baby will have an easier time sliding through.

Plus, you may not have to push as much, which can protect your perineum from excess pressure and exertion.

Second, one way to avoid tearing during birth is to crown slowly. Crowning is the moment when your baby’s head reaches your vaginal opening. It’s the moment of biggest stretch.

If your baby moves slowly through that opening rather than shooting through forcefully, your perineal tissues will have more time to open and make room for your baby’s head. In order to have that kind of control, your pelvic floor will need to be strong. That’s where kegels come in.

To learn more about the 3 kinds of kegels and how to make sure you’re flexing your pelvic floor and not other muscles, check out the explanations in 6 Exercises to Prepare Your Body for Labor.

Pelvic Tilts

The next exercise you can do to prepare your perineum for birth is pelvic tilts. The benefit of pelvic tilts is more indirect, but still valid.

Pelvic tilts can help relieve lower back pain and other tension you feel as your belly grows. But they also help your baby to get into and stay in a good position for birth. That last one is the reason they can help you avoid tearing during birth, as I explained earlier.

To do a pelvic tilt, start by getting down on your hands and knees on a comfortable surface. Make sure your wrists are directly under your shoulders and your knees are directly under your hips. Relax your neck and shoulders, allowing them to stay in a neutral position.

Take a deep breath in and, as you exhale, gently engage your abdominal muscles by drawing your belly button towards your spine. Tilt your pelvis forward and up slightly, doming your back gently, like a cat.

Hold this position for a few seconds.

Inhale and let your spine return to a neutral position. Repeat several times, focusing on smooth, controlled movements and keeping your breath steady.

Alternatively, you can use a birthing ball to do your pelvic tilts.

Walking

Walking is fantastic during pregnancy. It’s a gentle exercise so it’s a great option if more intense movement doesn’t feel doable. It can strengthen your leg muscles and helps you develop stamina so labor doesn’t wear you out too fast.

Walking during the last trimester of pregnancy is especially good for helping your baby get into a good position for birth (which, as covered, can mean less stretch required for your perineum).

Walking can also keep your pelvis aligned properly, which will keep you comfortable and make it easier for your baby to make his or her way through during labor.

If you are healthy, you can walk as much as feels good to you. Just avoid spending too much time in the heat and make sure you bring water!

Any and All Exercise

Finally, exercise in general, any kind, is good for you, your baby, and your perineum. I like to think of it as “cross-training.”

When a runner is training for a marathon, they run some days but other days they do cross-training. They might do a strength workout or yoga or go swimming or hiking.

The body is meant to move in multiple ways and the stronger and more flexible one muscle group is, the more it can support and complement others.

So while the exercises in this article are good for preventing tearing specifically, other workouts, like cardio and strength training, can help support you as a whole.

In short, the healthier you are, the easier and less exhausting labor will be.

Preventing Tearing During Birth: Beyond Exercises

As we’ve covered in this blog post, certain exercises can prepare your perineum and help prevent tearing during birth. Those exercises include child’s pose, deep squats, runner’s lunge, butterfly stretch, tailor sitting, kegels, pelvic tilts, walking, and any other exercise you want to do.

But while exercising can play a big role in helping you avoid tearing, there’s more pieces to the puzzle.

No single thing will ensure your perineum stays intact. Rather, doing these exercises AND eating well AND learning to relax your whole body and mind (and more) will work together to prevent tearing during birth.

To learn more about perineal tearing and other ways to prevent it, check out Perineal Tearing During Birth: What It Is and How to Avoid It.

The main thing I want you to remember is that tearing is not inevitable. You have a lot of power to prevent tears. Don’t believe anyone who tells you tearing is unavoidable. Make intentional choices now and during labor, and don’t give in to fear. Your perineum will thank you.

Until next time,

Allison

P.S. To learn more about episiotomies and the 12 other interventions you might experience in the hospital, check out The Cascade of Interventions [Explained].

READ MORE:

The Best At-Home Pregnancy Workouts

How to Prepare for Natural Birth (In the Hospital or Not)

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