Let's talk about tearing.

Feb 2026

This is a massive fear for so many women I work with.
It always comes up during birth prep and yes I HEAR YOU, it sounds pretty awful to tear during childbirth.

I usually encourage a twofold approach to tearing, firstly to to reduce the risk and severity of tearing, but also a mindset shift to acknowledge tearing as a normal and necessary part of birth for some. unfortunately we can't know who will tear, so it's worth getting your head around the possibility.

We are designed to unfold, to stretch, sometimes to tear, and then to HEAL. Your perineum is able to slowly stretch and expand as your baby comes down, and even though it feels intense, and you might want to get it over and done with ASAP, the slower the better!

The most awful but fitting analogy I have is that your perineum is like the crumple zone of a car. Tearing is sometimes an inevitable part of birth, the perineum is there to take impact and protect more essential areas of your body (yes, babe, I mean your bum hole).

BUT (pun intended 🍑 😏) There is so much we can do to reduce the risk and severity of tearing.

Here's some of my top tips:

Having freedom of movement throughout labour and birth,
using movements and positions which are instinctive,
remaining mobile and off your back in labour (opright, forward, open positions)
Using warm water,
- Bath or birth pool
- having the shower running over your lower back,
- warm compress if it feels good
Using your breath and visualisations to guide gentle, instinctive pushing
little puffs of breath at the height of crowning to slow the stretch (blow out little candles!)
Don't hold your breath and PUSH like we see in films and TV.
choose an environment and team that helps you feel safe, supported and unhurried.
Trust your body instead of fighting it, let go of tension.
relax your tongue, jaw and shoulders, to relax your pelvic floor!

What if I do tear?

Tearing is not a failure. It's your body doing its best in a powerful, intense, full capacity moment, bringing a whole new life into the world. Most tears are small, and heal well when supported by good care, good blood flow, nutrition and rest.

Stitches aren't always needed, and part of my role is to help you gather all the information you need to decide what the right course of action is for you, whether it's leaving things to heal naturally, having stitches where you are, transferring into hospital, or in more serious cases into theatre.

I've seen a few stitch-uations in my time (and had one myself) and I assure you, things will heal. It's a great excuse for bed rest with your precious new babe and to be cared for by others while you recover.

Fear tightens. Trust softens.
Your body is not fragile.
It is clever and responsive.
You have capacity to stretch and heal.

Musing on Inductions

Feb 2026

If you're pregnant you can be pretty sure you'll be offered an induction at some point. It's not my job to influence your decisions about birth, but I want you to feel confident about those decisions, and prepared for what comes next!

An induction can be beneficial in certain circumstances when it would be safer to have your baby sooner rather than later due to risks to your of your baby, as long as you are feeling well enough to have a vaginal birth.

Often induction is suggested due to potential risks based on populations of people or guidelines, rather than looking at someone's individual risks. In many cases it's just as safe (sometimes safer) to wait for labour to start in its own time. It can feel like there's a lot of pressure to accept an induction which can be stressful, but this decision has to be yours, and you should be supported whatever you choose.

If you are considering an induction then listen up!

This can be the start of a great birth experience, but you've got to go in with your eyes WIDE open and your wits about you!

Top tips for a positive induction

Before you start:

Be sure of your decision, and take your time to make it. If you're starting your labour reluctantly it can impact your mindset. Fear, doubt and regret won't help your birth process.
Prepare for the long haul. Induction can take many days, don't expect fast results. If your baby arrives soon then bonus!
Be prepared for intensity. The induction process can lead to more sudden and more painful contractions.
Get your team ready. You need steady grounding support through this process. Birth partners need to be prepared to ride those intense waves with presence, help you feel calm and safe, and advocate for you if needed.

During the labour:

Don't underestimate the power of your own natural oxytocin. Your body and hormones are still major participants in this birth. Use all your tools and strategies to boost natural oxytocin; safe calming environment, positive and soothing vibes, loving support from your birth partner/s.
Take your comfort measures seriously; movement, breath, Hypnobirthing, tens/ comb and massage can all help.
Learn about medical pain relief options before you start so you can make informed decisions along the way.
This is NOT a conveyor belt. You can choose to stop or wait at any point in the induction process. One thing doesn't necessarily lead to another. It's your decision every step of the way.

Non- medical pain relief for birth

Feb 2026

Did you know your body comes fully equipped with its own powerful pain relief for labour?

Endorphines!

As labour progresses, your body produces endorphins, incredible feel-good hormones that can be up to 200 times stronger than morphine. They help you sink into your birthing zone, soften the edges of intensity, and create a calmer, more euphoric state.

But here’s the thing: endorphins flow best when you feel safe, supported, and undisturbed. If fear or stress take over, adrenaline can push them aside, making contractions feel more painful and labour harder to manage, and making you question whether you really can get through it.

Ways to boost your natural endorphin production in labour:

Dim the lights: darkness and privacy encourage oxytocin and endorphins.

Listen to music you love: rhythm and relaxation increase those feel-good hormones, and movement and swaying can also release tension.

Connection: cuddles, hand-holding, gentle touch, or even kissing can keep the oxytocin–endorphin cycle flowing.

Breathing techniques & hypnobirthing tools: calm your nervous system, reduce fear, and let endorphins rise.

Trust your body: surrendering to the rhythm of contractions rather than fighting them helps your body’s natural chemistry do its work.

Birth isn’t just about “getting through” the pain, it’s about working with your body and tapping into the hormones designed to support you. You are wired for this.

Other natural comfort measures:

Birth Comb/ orbs, pressed into the palm
TENS machine on the lower back

Both of these make use of 'Gate Control Theory,' which tells us that the brain can only focus on one intense sensation at once, essentially distracting you from the labour pains.

Massage
Movement
Hot water
Hot/ cold flannels to neck, shoulders, back.
Hypnobirthing:
- Breathing
- Affirmation
- Mindset tools
- Relaxation.

Whatever tools you take, love and support are the greatest comfort measures during labour. A responsive partner who is able to meet your emotional and physical needs can make all the difference.

The right to decline.

Feb 2026

Too often, people giving birth are made to feel like passengers in their experience. Let’s be clear, you have full legal rights to make decisions about your care during pregnancy and birth, including saying no to ANY intervention.

Way too often that "no" is followed up by coercion, guilt trips, pressure and disregard for your autonomy and choice, causing stress, doubt, fear and trauma.

A woman in labour shouldn't be having to work hard to advocate for decisions she has made. She should be respected in her decision making, but sadly disrespect, coercion and pressure is the reality for so many.

During over a decade working as a Specialist Speech and Language Therapist, I have supported hundreds of people through complex decisions in the medical setting so I'm sharing my top tips with you here!

What the law says:

You must be given clear information about the risks, benefits, and alternatives to any proposed intervention.
You must have the time and support to make that decision freely, without pressure, coercion, or fear.
Every adult is presumed to have the capacity (ability) to make their own decisions, including during labour. If there is concern that you aren't able to make this decision due to a disturbance in the function of your mind or brain then a formal assessment should be completed and documented.
Even if a professional disagrees with your decision or feels it is unwise, it's your body, your baby, and your choice.

So what can you DO?

“I do not consent” is a full sentence. You don't need to justify or explain your decision.
Ask for the reason for the recommendation, the fact that you are declining, as well as any further conversations to be documented in full.
Call out coersion. If you feel you are being pressured into an intervention then speak out and ask for a different clinician. You can also write a formal complaint afterwards to your trusts PALS service.
Ask for a different care provider, or to speak to a more senior clinician, and keep asking until you find someone who accepts your decision.
Have a birth partner or doula ready to advocate for you, they should be well informed about rights in childbirth and ready to step up for you if your wishes aren't being respected

Birth isn't about doing what you are told, it's about following your instincts and doing what's right for you and your family.