Some preventative measures for perenial tears are a nourishing diet for tissue integrity and strength (whole grains, nuts and seeds which contain a high amount of natural vitamin E, good nutrition prior to and during pregnancy, consider what germ oil supplementation if tissue integrity is in question. Do not overdo vitamin E supplementation though...it can cause a placenta to implant too deeply into the uterine wall.), perenial massage and not blasting baby out (when you feel the ring of fire that means tissues are stretching and take that as a cue to gently push baby's head out!). Also, certain pushing positions are better than others for minimizing tears. The side lying position brings about a slower birth and the fewest perenial tears. With my first I HAD to squat though because I would have been pushing for way more than an hour otherwise!
If mom gets a tear:
Comfrey Rinse. 1 ounce of comfrey leaves, 1 ounce of Echinachea, 1 pinch of golden seal. Bring the above herbs to a slow boil in one quart of water. Turn off heat and let steep one hour. Store in refrigerator and use as a perenial rinse with each bathroom visit. Can be used as an herbal compress by soaking sterile gauze and applying to the lacerated or stitched area.
Lavender baths. 5-7 drops in 8 inches of warm water for a week to ten days for 20 minutes for healing for a sore perenial area.
Light therapy. Sit with bottom up in the sunlight for 15 to 30 minutes several times daily. You can use a 40 to 60 watt light bulb held one foot from the bottom for 10-15 minutes for similar results.
Keep knees together. It's really important to stay in a reclining or semi-reclining position with knees together until healing of perineal tissue is underway.
Kegels (before and after birth) to hold up and support mom's internal structures and can help hold together any tissue that has torn until healing can occur.
Sources: Naturally Healthy Pregnancy by Shonda Parker, Birthing From Within, and The Birth Book.
I have never torn but have had a tender and sore perenium though. I like to do a healing herb bath soon after birth, the lavendar baths and to use a pernial wash of water with a few drops of tea tree oil instead of wiping for the first few days or so pp. I'd like to have some comfrey on hand for this birth just in case I tear too. A mom mentioned in this thread that she tore with her fourth? birth. I would have never guessed! I figured when you've birthed 3 without a tear that your probably gonna be just fine. I'm about to have my fourth