How to Prevent Tearing During Labor
Wondering how to prevent tearing during labor? While no one can guarantee you won't tear during childbirth, there are evidence-based ways to reduce your risk of more severe tears. In this guide, you'll learn what causes perineal tearing, how the pelvic floor stretches during birth, and practical strategies to prepare your body, including pelvic floor physical therapy during pregnancy, perineal massage, breathing techniques, pushing strategies, and labor positions. Whether you're looking for a pregnancy PT in Chicago or simply want to feel more confident heading into labor, this article will help you understand how to prepare for birth with knowledge, confidence, and support.
Whether you're looking for a pregnancy PT in Chicago or simply searching for a pregnancy PT near me, this guide will explain what causes tearing, what actually helps, and how working with a pelvic floor physical therapist can help you feel more confident heading into labor.
One of the biggest fears many pregnant people have about childbirth isn't contractions...
It's tearing.
Or whether they're going to poop during labor.
(Spoiler alert...you might, and that's completely okay. 💩)
The good news?
While you can't completely eliminate the possibility of tearing, there are several ways to reduce your risk of more severe tears and help your body prepare for birth.
It's also important to know that perineal tears during vaginal birth are common, and not every tear is considered severe or concerning. What matters most is feeling educated, empowered, and prepared before labor begins.
That's exactly where pelvic floor physical therapy during pregnancy can help.
What Causes Tearing During Labor?
You've probably seen those pregnancy apps comparing your cervix to fruit or bagels as it dilates during labor.
When we think about labor progression, we often focus on reaching 10 centimeters of dilation. But that's only one part of the story.
The cervix opening allows your baby's head to begin moving through the birth canal. From there, the vaginal tissues and pelvic floor muscles continue to stretch significantly to allow your baby to be born.
In fact, the pelvic floor muscles can stretch 2.5 to 3 times their resting length during vaginal delivery. That's incredible! But sometimes those tissues are simply stretched beyond their capacity, which is why tearing can happen.
Several factors can increase the likelihood of tearing:
First Vaginal Birth
First-time vaginal births are more likely to result in tearing because the tissues have never stretched to this degree before.
Baby's Size or Position
Babies with larger head circumferences or babies who are positioned "sunny side up" (occiput posterior) may place more pressure on the vaginal opening and perineum during delivery.
A Fast Delivery
When labor progresses very quickly, the tissues have less time to gradually stretch and adapt. A slower, controlled birth of the baby's head often gives the perineum more time to lengthen.
Instrument-Assisted Delivery
The use of forceps or a vacuum-assisted delivery is associated with a higher risk of tearing.
Can You Prevent Tearing During Labor?
This answer isn't completely straightforward.
Can we guarantee that you won't tear?
No.
Can we reduce the severity of tearing?
Absolutely!
Research continues to show that preparing your body during pregnancy can make a meaningful difference. Pelvic floor physical therapists are specially trained to teach you techniques that improve tissue mobility, pelvic floor coordination, breathing mechanics, and pushing strategies, all of which can help your body better adapt during birth.
Preparing Your Body for Birth Starts Before Labor
This is where pregnancy pelvic floor physical therapy really shines.
One of the best things you can do during pregnancy is work with a pelvic health physical therapist. And contrary to what many people think, you don't have to wait until the third trimester to start. Not sure when to begin? Read our blog on When to Start Pelvic Floor Therapy During Pregnancy to learn what we focus on during each stage.
Each trimester has different goals.
As your pregnancy progresses, your body changes, your baby grows, and your movement patterns adapt. During physical therapy, we focus on improving mobility, building strength and endurance, preparing your body for labor, and teaching you how to both strengthen and relax your pelvic floor.
Here's how we help.
Pelvic Floor Awareness and Relaxation
We use hands-on treatment, breathing techniques, and visual cues to teach you how to lengthen and relax your pelvic floor in different labor positions.
Hip, Pelvic, and Whole-Body Mobility
Your hips, pelvis, spine, and rib cage all influence how your body moves during labor. We improve mobility where needed so your body can move more freely throughout the different stages of labor.
Breathing and Pushing Strategies
We'll teach you the difference between open and closed glottis pushing, when each may be helpful, and how to push efficiently without creating unnecessary tension.
Most importantly, we help you learn how to listen to your body and feel confident making decisions during labor.
Perineal Massage Education
Around 32-34 weeks of pregnancy, we teach patients and their partners how to perform perineal massage safely. Perineal massage isn't just about stretching tissue. It's also an opportunity to practice breathing through discomfort and learning how to consciously relax your pelvic floor when you feel pressure.
Relaxation Over Tension: Why Your Pelvic Floor Needs to Lengthen
One of the biggest myths I hear is that pregnant people should do hundreds of Kegels every day to prepare for birth.
Honestly...this advice makes me cringe.
Don't get me wrong. Strength matters.
Your pelvic floor needs endurance to support your growing baby throughout pregnancy.
But labor isn't about squeezing harder.
Birth requires your pelvic floor muscles to lengthen.
When your uterus contracts, your pelvic floor needs to relax and move out of the way so your baby can descend through the birth canal. If those muscles reflexively tighten every time you experience pressure or discomfort, it becomes much harder for them to stretch efficiently.
One of the biggest goals of pregnancy pelvic floor physical therapy is teaching your body when to contract and, just as importantly, when to let go.
What Is the Best Birth Position to Prevent Tearing?
Patients ask me all the time:
"What's the best position to give birth in?"
My answer is always the same.
The best position is the one where you feel the safest, most relaxed, and most in control.
There isn't one perfect birth position for everyone.
Your body may naturally want to change positions throughout labor, and that's okay.
If you do find yourself pushing on your back, there are still ways to optimize that position. For example, placing a small towel under your sacrum may allow your tailbone a little more freedom to move. Bringing your knees in during pushing may also help maximize the opening of the pelvic outlet.
Some common birth positions include:
Side-lying
Hands and knees
Supported squatting
Kneeling or leaning forward
Lying on your back
The goal isn't finding the "perfect" position.
The goal is finding the position that allows your body to relax.
How to Feel More Confident Going Into Labor
If there's one thing I hope you take away from this article, it's this:
Your body doesn't need to be perfect.
It needs to be prepared.
The fear of tearing, or even pooping during labor, is completely valid. But with education, preparation, and guidance, you can approach birth with confidence instead of fear.
While we can't promise you won't tear, we can help reduce the risk of more severe tearing by improving pelvic floor awareness, breathing mechanics, mobility, tissue flexibility, and pushing strategies throughout pregnancy.
Prepare for Birth with Envision Pelvic Health & Wellness
If you're looking for pregnancy PT in Chicago or searching for a pregnancy physical therapist near you, we'd love to help.
At Envision Pelvic Health & Wellness, our pelvic floor physical therapists work with pregnant patients every day to prepare their bodies for labor, delivery, and postpartum recovery. Whether you're experiencing pelvic pain, back pain, bladder symptoms, or simply want to feel more prepared for birth, we're here to guide you every step of the way.
Our clinic proudly serves Chicago, including Norwood Park, Edison Park, Park Ridge, Niles, Des Plaines, Jefferson Park, and the surrounding northwest suburbs.
Ready to prepare for birth with confidence? Schedule a pregnancy pelvic floor physical therapy evaluation today and let's build a plan that's personalized for you.
Learn more about our team here , and explore our pregnancy and postpartum services.
If you have questions about insurance, cost, or whether pelvic floor therapy is right for you, we are here to help.
You are welcome to:
Book a discovery call
Call the clinic with questions
Learn more about payment & reimbursement
Book a discovery call or submit a contact form today to learn more.
Or, if you’re ready to book your initial evaluation use the link below.
Frequently Asked Questions
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Pelvic floor physical therapy cannot guarantee that you won't tear during childbirth. However, research suggests it can help reduce the risk of more severe tears by improving pelvic floor mobility, teaching relaxation strategies, optimizing pushing mechanics, and preparing your body for labor.
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It's never too early. Many people benefit from starting during the first or second trimester, while others begin later in pregnancy to focus specifically on birth preparation. Every trimester has different goals, and a pregnancy physical therapist can tailor treatment to your needs. Read our blog When to Start Pelvic Floor Therapy During Pregnancy.
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Research suggests that regular perineal massage beginning around 32- 34 weeks of pregnancy may reduce the risk of more severe tearing, particularly for first-time vaginal births. It can also help you become more comfortable relaxing your pelvic floor during stretching.
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Not necessarily. While pelvic floor strength is important during pregnancy, labor requires your pelvic floor muscles to relax and lengthen. A pelvic floor physical therapist can help determine whether you would benefit more from strengthening, relaxation, or a combination of both.
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Absolutely! Many people come to pregnancy PT simply because they want to prepare for labor and delivery. Pregnancy physical therapy isn't just about treating pain—it's also about education, birth preparation, breathing, pushing strategies, pelvic floor coordination, and postpartum planning.