Is it worth a try?
If you are approaching your final semester and are close to delivery, chances are you have already heard a few people explaining to you about perineal massage – the art of gently stretching the skin between the vagina and anus in order to ‘condition’ the tissue for birth. The theory is that having a more stretchable perineum reduces the risks of tearing during delivery and may even help you avoid and episiotomy.
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Does it Work?
Perineal massage during late pregnancy has long been supported by anecdotal evidence, but clinical research has been less conclusive; however, a recent review of randomized, controlled studies of complementary and alternative medicine practices used during pregnancy showed that perineal massage may truly be helpful.
The studies also showed that perineal massage works best for women who are having their first baby. If you have had an episiotomy or tearing in a previous delivery, perineal massage may not work as well for you. In multiparous women who have had previous episiotomies, the perineum contains scar tissue that is weaker than normal tissue, so the perineum will be more likely to tear at subsequent deliveries and will be less likely to respond to massage.
Perineal massage is also more likely to be of extra help to women over the age of 30 as older tissues are known to be stiffer than younger tissues.
Should I try it?
Experts of perineal massage point out that perineal massage may have other benefits besides stretching the perineum. If practiced regularly, perineum massage may help you cope with the stinging sensation you will start feeling when your baby’s head crowns.
In addition to that, perineal massage may have the effect of focusing the mother’s determination. The type of woman who wants to do perineal massage is the same one who is motivated to find a care provider who blends with her birth philosophy and who will work with her for the extra time it takes to deliver baby gently and slowly.
Many couples wonder is perineal massage is safe, but just like any other complementary or alternative therapy you plan on trying during pregnancy, it is best to check with your healthcare provider beforehand. Experts say that if perineal massage is not done properly, it could harm you and your baby. It is extremely important to use adequate lubrication and avoid too much force.
Women who have had preterm labour, premature rupture of membranes, vaginal infections or feel like perineal massage is causing you too much discomfort are encouraged to avoid this massage at all cause.
It is important to keep in mind that at the end of the day, birth is unpredictable by nature and sometimes and episiotomy may be necessary, even for highly prepared for births.
A How-To Guide!
Once you reach about 34 weeks into your pregnancy, you could include perineal massage as one of your preparations for childbirth. As of now, there is no schedule on how often you should massage your perineum, but there have been studies conducted that showed women who massaged more frequently had a smoother and tear-free birth.
However, a contradicting study showed that women who massaged their perineum 1.5 times a week on average delivered without needing an episiotomy compared to women who massaged their perineum more frequently. As mentioned earlier, it all comes down to how your body copes naturally. You could try getting some advice from your healthcare provider before starting your perineal massage.
What Will I Need?
- Clean hands with trimmed nails (yours or your partner’s)
- Some pillows
- Mirror – if you are doing the massage yourself so that you would know what you are doing
- A gentle touch
- Massage oil or water based lubricant
Step-By-Step Guide to Perineal Massage
#1 Find a quiet, private place to lie down. Place the pillows in such a way to support your back while you lay in a semi upright position. Dim the lights and turn on some calming music to help you stay relaxed.
#2 Apply the massage oil or lubricant onto your fingers, thumbs and perineum. The oil or lubricant used should not cause you any sort of discomfort.
#3 Next, insert two fingers around 3-4cm deep into your vagina. Gently, but firmly, apply pressure towards your anus. At the same time, gently pull your two fingers apart so that your perineum is being stretched both downwards and outwards. Keep applying pressure until you feel a slight tingling sensation, this is your perineum being gently stretched.
#4 Imagine that your vaginal opening is a clock face. Next, pull your two fingers down to 6, then stretch them outwards and upwards towards 3, applying pressure. Repeat this 20 or 30 times, and then move to the other side and repeat the same motion 20 or 30 times from 6 to 9.
#5 Stretch the perineum externally. Place two or three fingers from each hand in the centre of your perineum, and stretch the skin outwards towards your thighs.
#6 Next, place your fingers in a V in the middle of your perineum and pull upwards towards your vaginal opening.
#7 Finally, place your thumbs in the middle of your perineum, and push them apart in opposite directions.