By Lovetti Lafua
Nurse • Midwife • Biologist • Human Optimization Researcher

True perineal care begins long before the postpartum period—it is woven into the fabric of the birth itself. While traditional wisdom offers powerful tools for healing, its greatest gift is the knowledge of how to prevent trauma in the first place.

Tear Prevention and Physiologic Birth

A growing body of research confirms what midwives have always known: coached pushing and forceful delivery significantly increase perineal trauma and pelvic floor injury. The traditional midwifery approach avoids this by trusting the body to guide the birthing process.

The cervix is drawn upward by powerful uterine contractions, not pushed outward by the mother’s forced effort. The fundus (the top of the uterus) expels the baby far more efficiently than abdominal effort alone. This fetal ejection reflex, now recognized in modern obstetrics, has been respected by midwives for centuries.

Allowing the birth to proceed spontaneously minimizes tears. Slowing the birth of the head allows tissue to stretch gradually and effectively. Mothers who experience this kind of physiologic birth consistently report less soreness, faster recovery, and a greater sense of wholeness and empowerment.

Integrating Evidence and Tradition

Traditional wisdom and modern evidence intersect in profound ways: maternal nutrition supports placental health, gentle physiologic birth reduces trauma, and emotional readiness influences outcomes. By honoring both science and tradition, we create a birth experience that is safe, holistic, and deeply empowering for a lifetime.