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Top tips that may help prevent tearing during labour.

Perineal Massage


So this may feel a bit out there and possibly out of your comfort zone but bare with me!


So for starters where the heck is you perineum? Well, it is the space between your anus and vagina. Your perineum connects with the muscles of the pelvic floor. You have probably heard about pelvic floor exercises and how important they are to do (you may well be doing them now as I have just reminded you!!). The pelvic floor is a hammock of muscles which supports your pelvic organs, such as your bladder and bowels. Stretching or tearing of the perineum during labour can affect the support that your pelvic floor gives.


How am I supposed to massage it may be your next question and what is the point?


Let me tell you.


So, research has suggested that perineal massage may improve elasticity and prevent tearing. It can be done regularly from 34/35 weeks.


Advantages (some taken from Antenatal perineal massage by Oxford University Hospitals)

  • It can increase the elasticity of the perineum. It improves the perineum’s blood flow and ability to stretch more easily and less painfully during the birth of your baby.

  • Tears in the perineum are less likely and you are less likely to need an episiotomy. An episiotomy is a cut to the perineum that is sometimes performed to speed up the birth of your baby or to help prevent a more severe tear. You should always be asked before one is performed.

  • It helps you focus on the feeling of your perineum opening up

  • Your perineum is less likely to be painful after the birth of your baby

  • It is quite easy to do and doesn’t require anything special


Disadvantages


  • It can be tricky to do

  • It can feel uncomfortable

  • There are no guarantees it will help


If you decide that it is something you want to try then here’s how


It can be done by you or your partner. You may want to start off doing it and get a feel for it and then ask your partner to help. A good time to do it is after a bath or shower as you may feel more relaxed and blood vessels in the area are dilated. This makes the perineum softer and more comfortable to touch.


Use an oil to help lubricate the area. This could be a simple organic coconut, olive, sunflower or grapeseed oil or an oil that is produced specifically for the task such as Weleda’s perineum massage oil.


I am now going to link to Weleda’s excellent explanation and diagrams about perineal massage as it is a lot clearer than me describing it!


https://www.weleda.co.uk/perineal-massage


Another great page for information is

https://www.rcog.org.uk/en/patients/tears/reducing-risk/


If you decide that perineal massage isn’t for you but you think the theory makes sense then another option is to buy an Epi-no if you have a spare £99 https://epi-no.co.uk/




Other things to do during labour that may help


  • Listen to your body and move into positions that feel comfortable for you. All fours, lying on your side and kneeling can be effective positions

  • Listen to your body’s urges when pushing so pushing when you feel the urge to rather than when someone is telling you to and then pushing too hard. Forced pushing involves holding your breath and therefore creates tension in our bodies and means the baby is descending on to hard, tense muscles and we are more likely to tear.

  • Deep breathing means a greater intake of oxygen. So breathing deeply during the birthing phase sends oxygen to the birthing muscles and helps them open and relax. Baby can then descend more gently.

  • Being in water certainly helps with changing position more easily and giving birth in a birth pool has shown lower rates of episiotomies and possibly lower rates of 3rd and 4th-degree tears. There are also higher rates of intact perineum in high episiotomy settings but a possible higher rate of minor labial tears in a low episiotomy setting. Please have a read of https://evidencebasedbirth.com/waterbirth/ for more information and links to the studies.

  • Warm compress - this can be placed on the perineum as the baby’s head stretches the tissues.



I hope this has helped explain things and given you some food for thought. Please try not to worry about it too much but if it helps to feel you are doing something productive then have a go at the massage.


Love, Lucie xx


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