There are many different things that you can do to better prep for labor and delivery. One of these things is doing a perineal massage during pregnancy. The perineum is the muscle and skin between the anus and vagina.
What Can Happen to the Perineum During Childbirth?
The intense pressure that occurs when giving birth can cause a tear in the perineum. Obstetricians attempt to avoid the tear by performing an episiotomy, which is a surgical cut to the vaginal opening. The cut provides more space for the baby’s passage. Nearly half of all women who experience a vaginal birth will have a perineal tear that may or may not require stitches. After a perineal tear, women can experience discomfort and sexual difficulties for several months. Fortunately, there are steps expectant mothers can take to prepare the perineum for delivery. One particularly effective step is to perform perineal massage.
Massaging the Perineum Helps Prevent Tearing
Perineal massage involves massaging the area between the vagina and bottom. It is typically performed late in the pregnancy and helps to prepare the perineum for childbirth. It is customary for expectant moms to start a regular massage regimen around the 34th week of pregnancy. The massage involves gentle stretching of the tissues that surround and shape the birth canal.
Perineal massage is an ancient practice that has been proven to increase the chances of delivering a baby vaginally without damage to the perineum. Perineal tears require stitches and can lengthen the recovery time. This can also cause fecal or urinary incontinence. By just dedicating five to ten minutes each day to massage, trauma to the perineum can be prevented.
Preparing the Perineum for Delivery
The tissues of the perineum create strong pelvic floor muscles. This is what allows you to walk standing upright and prevents you from leaking urine when you cough. It is important that these tissues are strong and able to withstand the pressure of delivery. They also need to be flexible enough to stretch so the baby can pass through the birth canal.
Unfortunately, the perineal tissue sometimes lacks the flexibility needed and is not able to stretch enough during delivery. The delicate motion of the massage keeps the perineal tissues supple and trains them to relax and expand naturally during the delivery. While massaging, practice breathing through the sensation of the perineal stretching.
Women who have performed perineal massage report that they feel more relaxed during labor. Massaging can make the area more flexible and pliable. This can be particularly true for women giving birth for the first time. It is also a good idea to perform pelvic floor exercises to strengthen the pelvis throughout pregnancy.
Massage Tips and Instructions
As the 34th week of pregnancy approaches, speak with your doctor or midwife about a perineal massage routine. Once you have been given the green light from your health care provider, dedicate at least five minutes a day for the massage routine. You can perform the massage on yourself or you can have your partner help. Regular massage is the best way to promote elasticity. Do not become disheartened if you happen to miss a day or two. Just pick back up and re-dedicate yourself to a routine.
Here are the basic steps for a perineal massage :
1. Before starting the massage, make sure your hands are clean and nails trimmed.
2. Get into a comfortable position that will allow you to reach your perineum. Try sitting propped up on the bed with your knees bent or try squatting against the wall for support. Feel free to make changes to the position if you experience discomfort.
3. Pour a dime-sized amount of massage gel onto your fingers and apply it to the area. Be sure your thumbs and fingers are well-lubricated. Using a massaging gel helps to make the massage more comfortable and helps to hydrate the tissues. Avoid using coconut oil or almond oil. Some natural oils contain inflammatory and oxidative chemicals that can increase the chances of getting a vaginal infection. Also, stay away from water-soluble lubricants. The salt and ion concentration may cause irritation. There are massage gels created specifically for perineal massage.
4. The massage can be performed with index or middle fingers. Insert the fingers about an inch inside the vaginal opening and rest your palms against the inside of your leg. The goal is to massage and stretch the back area of the birth canal, down towards the anus. You want to intensify the pressure over time. Be sure to consciously relax the muscles as you go.
5. Continue the massage for five minutes. Re-apply massage gel if needed.
6. If you are performing the massage with your partner, sit facing him or her with your legs draped over your partner’s. The same techniques as described above can be used.
Perineal massage can feel awkward and even painful when you first start. Over time, it will be easier and more comfortable. It just takes a few minutes a day to prepare for a tear-and-stitch-free delivery.
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