Perineal massage; A way to avoid episiotomy

“How will I push something the size of a small watermelon out of my body without breaking into two?”-

This is one among the many questions pregnant women ask. The fear of tearing the perineum during child birth. A lot of mothers do suffer this tear of the perineum on their first child birth. Thanks to episiotomy, a surgical cut between the vagina and anus to aid in delivery.

Is it possible to avoid tearing of the perineum during child birth? Is it possible to deliver your baby without episiotomy? Is there a way to prepare your body for that great big stretch during childbirth?
Yes.

In recent times, it has been known that perineal massage throughout pregnancy had helped reduce episiotomies by 16% for first-time mothers, though it did not reduce the risk of episiotomy for experienced moms.

Why is this important?
The idea is that gently stretching the perineum regularly will allow it to stretch more easily when baby is crowning, causing less pain and no tear.

THE PERINEUM

The perineum is the soft skin that is between the anus and the vagina. This delicate area is prone to tearing (especially for women having their first vaginal birth) because of its proximity to where the baby exits the vaginal canal, as well as the pressure put on it while pushing. It is important to note that not all tears are the same. Some are tiny, heal quickly, and require no special treatment while others may end up on the other end of the spectrum with deep lacerations requiring stitches and weeks of healing and discomfort.

What is perineal massage?

Perineal massage is massaging the perineum (just as what it sounds like). Some women do it for themselves, and others will ask their partners to help. Often, it is done throughout pregnancy to stretch and increase flexibility in the perineum in preparation for birth, in hopes of keeping the area intact or at least minimizing perineal trauma during delivery.

Items needed for a perineal massage

• Clean hands with neatly trimmed nails
• Safe, non-toxic and non-irritating massage oil like almond oil, vitamin e oil, or coconut oil
• A clean towel
• A mirror (This is optional especially if administered by your partner).

How to administer perineal massage

This can be done by yourself or with the help of your partner. Either way, these steps should be followed.

• Take a warm bath or use a warm washcloth compress to soften the area for 10 minutes.

• Lay in a comfortable position on a clean towel. Try propping your back up with pillows. Position mirror if needed.
Keep yourself relaxed and calm so that your bottom can be relaxed and calm too.

• Apply massage oil to the perineum.

• Insert one or two thumbs about an inch into your vagina (about to your thumb’s knuckle) and put firm but gentle pressure straight down on the perineum. Allow the perineum to stretch for a minute or two so you may be able to get the second thumb in more easily. Slight burning or stretching is OK, but if you experience pain, use more gentle pressure, or better to stop the massage.

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• Once the perineum has been stretched for a couple of minutes, gently move your thumb up along the sides of the vagina, stretching it from side to side. This should be done like running your thumb on the inside of a bowl from one side to the other.

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• If you are using two thumbs, you can run them from the bottom up to each side like you’re starting with your thumbs at the bottom of the bowl and running them up opposite sides. Continue this for 3–5 minutes or as long as is comfortable to you.

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NOTE If you’re having trouble reaching your perineum or you are not comfortable with someone(your partner) helping out but still want to do the massage yourself, you can prop one foot up onto a chair or toilet seat (so that you’re in a lunge position) and perform the massage as described above.

I know someone would ask "when do pregnant women start the perineal massage?" Well, It is best to start the prenatal perineal massage around 34 weeks as any earlier than this will be waste of your time.

Do not forget to share this piece of information with others.

REFERENCE: https://mamanatural.com/perineal-massage/
https://bellybelly.com.au/pregnancy/perineal-massage
https://babycenter.com/Pregnancy/Giving-Birth/Labor-&-Delivery