#353 | No Stitches Required: Preventing & Healing Perineal Tears in Birth

February 4, 2026

Tearing is one of the most common fears around birth—and one of the most misunderstood. In this episode, we talk about what really causes tearing, what the research shows, and what you can do to reduce your risk. We cover perineal massage, positions for birth, breathing and pacing, water birth, warm compresses, and what makes recovery smoother.

Through the episode, we review our followers' real-life "tearing" stories, and provide our commentary, which includes labial tears, scar tissue, pelvic floor recovery, over-stitching and unnecessary repairs, how beliefs and fear affect pushing, poor suturing techniques, the harm caused by routine episiotomies and the so-called, absolutely outrageous, “husband stitch”. 

This is an honest, evidence-based conversation about the perineum—how to protect it, how to heal, and what every woman can know before giving birth.

Watch our full Preventing Perineal Tears workshop on Patreon.com/DownToBirthShow.

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If you enjoyed this podcast episode of the Down To Birth Show, please share with your pregnant and postpartum friends.

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You can reach us at Contact@DownToBirthShow.com or call (802) 438-3696 (802-GET-DOWN). 

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About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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