7 Exercises to Prevent Tearing During Birth
Tearing during birth may be common, but it’s not unavoidable. And you don’t need to be afraid of it. Seven exercises can help you prevent tearing during birth. Learn about each, plus the #1 thing that can help you avoid tearing.
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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.
Chances are, you’ve learned that some women tear while giving birth (their perineum, that is). And if you’re like most women, that thought sounds pretty scary.
Why Not to Be Scared of Tearing
Here’s the thing: tearing is common. But most of the time it’s minor scrapes that don’t need any stitches.
Even more important than that? Tearing isn’t necessarily a bad thing. It sounds scary, yes, but just like our bodies were created to give birth, they were created to heal!
AND here’s the other thing. You likely aren’t going to notice or care that you tore in the midst of meeting your baby for the first time and the flood of hormones. The pressure of your baby’s head numbs your perineum, so you won’t feel it. And your focus will be on the joy of meeting your baby for the first time.
So while it sounds scary, it’s really not.
Having said all that, if you still want to do something to prepare your perineum—not out of fear but because you want to support your body—keep reading to learn all about how exercise may be able to help you prevent tears.
READ MORE >> Perineal Tearing During Birth: What It Is and How to Avoid It
A Word on Perineal Massage
Let’s start with a common piece of advice: perineal massage.
You’ve probably heard about doing it during the last few weeks of pregnancy—I did 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 doesn’t offer much benefit either.
The research shows a few key points:
- Perineal massage only helps first-time moms. Mothers who have given birth before see no benefit from doing it.
- The benefit to first-time moms was only seen in studies that looked at birth settings with extremely high episiotomy rates (over 20%). In the US (as of 2023), average episiotomy rates in hospitals are about 5%, which makes it hard to generalize those findings.
But how is perineal massage linked to episiotomies?
Most likely, it’s the mom.
The Best Thing You Can Do to Avoid Perineal Tearing
What we can conclude is that the kind of woman who does perineal massage is probably going to make other choices to protect her perineum, like refusing episiotomies or choosing care providers with low episiotomy rates.
And why is it important to avoid episiotomies? Because they are the leading cause of severe perineal tears.
That’s why your best bet to avoid tearing isn’t perineal massage (or exercise, even)—it’s carefully choosing a provider and birth location with a low episiotomy rate and ensuring 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…
- Relax and lengthen your pelvic floor,
- Strengthen your pelvic floor and legs to protect your perineum, and
- 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 tearing because if he or she isn’t aligned well, 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 stuff you came for. What exercises can you do during pregnancy to prevent tearing during birth? Not including perineal massage (for the reasons I gave above), there are 7 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.
How to Do 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.
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.
Why It Helps
Child’s pose helps to relax your pelvic floor, hips, and surrounding muscles helping them become more flexible and ready to open for your baby’s head.
Deep Squats
Next, let’s talk about deep squats. By “deep” I mean you’re all but sitting on the floor you’re so low.
How to Do a Deep Squat
Start by standing with your feet about hip-width apart 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.
Go as low as you can. Extend your arms forward for counterbalance if you need to.
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.
Why It Helps
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: runner’s lunge. This movement engages multiple muscle groups while also helping with flexibility and strength, both of which are important for birth.
How 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 greater.
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 to the side to make more room.
Why It Helps
Runner’s lunge helps to lengthen 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.
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 may be more accessible to you, especially if you are nearing the end of your pregnancy.
Butterfly Pose
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.
How to Do Butterfly Pose
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 allow your knees to fall 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.
Why It Helps
Butterfly Pose helps to lengthen the pelvic floor and inner thighs, which allows for more flexibility and relaxation.
Kegels
Kegels may seem a little counterintuitive if you’re thinking about how you need to be relaxed during birth. But kegels help you have a strong pelvic floor, and your pelvic floor is important in birth for a few reasons.
How to Do a Kegel
To do a kegel, sit up straight, with your weight in your sitz bones and your pelvis tilted slightly forward (not reclining).
Imagine you are urinating but want to stop the flow. Clench the muscles around your urethra, vagina, and anus. While you do this, keep one hand on your glute and the other on your inner thigh—those are different muscles and shouldn’t be moving.
If you’re having trouble identifying your pelvic floor, try coughing. The slight flick you feel at the base of your pelvis around those openings is your pelvic floor.
If you find it difficult to feel the contraction, it may just take some practice to become aware of those muscles. It could also mean that your pelvic floor is too tight, in which case you may not need to do kegels but stretches. (I talk about that in my prenatal nutrition and movement course, Strong, Nourished, Empowered.)
Why It Helps
First, the pelvic floor is what your baby’s head slides across as he or she is born. If your pelvic floor is toned your baby will have an easier time sliding through and rotating as they need to. That may mean you avoid prolonged pushing, which in turn can protect your perineum from excess exertion.
Second, having a strong pelvic floor may help you control crowning. 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 the vaginal 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.
Walking
Walking is great for you 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.
Why It Helps
Walking during the last trimester of pregnancy is especially good for helping your baby get into a good position for birth. Ideally, the crown of your baby’s head is the first to be born because that part of the head has the smallest diameter, meaning your perineum won’t have to open more than is absolutely necessary. (And thus you potentially avoid tearing.)
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 labor will be and the easier it will be to heal, whether you tear or not.
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. At the same time, there’s more to it than that.
How you eat comes into play, as does your ability to truly and completely relax. Your fears and emotions also affect you and your body.
Every element of your prenatal preparation and good habits works together to help you have a great birth experience.
The main things I want you to remember are…
1) Tearing is not inevitable. You have a lot of power in how you take care of yourself leading up to birth. And…
2) Just like your body was created to give birth, it was created to heal. So rather than giving into fear, trust your body. It’s got this.
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:
Perineal Tearing During Birth: What It Is and How to Avoid It
How Not to Be Scared of Giving Birth
