Your perineum, is the area between your vagina and your anus. It’s the area that takes a fair bit of stretching in childbirth, to accomodate your baby.
It is said that the perineum is designed to stretch and accomodate a baby, however, certain situations can make it more prone to tearing. These include:
- Poor Birthing positions (such as on your back..)
- The use of Forceps or Ventous extraction in birth
- Pushing too hard, or too early (can be as a result of coached pushing)
- Previous episiotomy scarring
Perineal massage, has anecdotally been shown to reduce the instance of tearing in childbirth, and many women find it an empowering and reassuring activity to embark on prior to labour. It’s best performed daily in the last 6 to 8 weeks of pregnancy (Or from approximately 34 weeks). It’s meant to hurt a little, like a chinese burn.
Here’s how you massage your perineum:
After your bath or shower, sit in a comfortable position. The bed is usually a good choice.
Put a water-soluble lubricant (Perineal Massage Oil, KY Jelly, or Olive Oil) on your perineum and on your hands. (If you’re using a lubricant for the first time, be sure to patch test first!)
Press downward towards the rectum and to the sides at the same time until a slight stretching, burning sensation is felt (NOT pain, just like a mild chinese burn)
Hold the pressure gently for about 30 seconds. Breathe Deeply and try to relax.
Keep pressing down with the thumb and slowly and gently
massage back and forth over the sides of the vagina in a ‘U’ movement for 3 minutes.
The idea is to gently stretch the perineum area, to make it as elastic as possible to allow your baby’s head to pass through.
Caution
Avoid pressure on the urethra (at the top of the vaginal opening, where you pass urine) Be sure to massage gently, as vigorous massage can result in bruising or swelling.
Other techniques that may assist in avoiding tears are warm packs and oil massages as the baby crowns. Gentle support of the perineum may well be all that is needed to help it stretch to accomodate a baby.
Birthing in water, improves the elasticity of the skin, and supports the perineum.
Lubricating the area with vitamin E or Jojoba oil daily in the last few weeks of pregnancy may help improve elasticity. You can also try olive oil, or almond oil. Be sure to patch test before you slather the whole area in something you may potentially be allergic to!
Consider nature, cows, rabits, dogs, cats (all animals to the best of my knowledge) birth in instinctive positions, not even considering the impact of tearing. Nature didn’t get it quite as wrong as our obstetritcians would have us believe…
And never underestimate the power of positive visualisation. Visualise your vagina stretching beautifully to accomodate your baby. Your body is very capable, and is designed to birth.
I have personally birthed 3 babies vaginally, the first baby was born in hospital and resulted in a 3 inch episiotomy. The second baby was born at home in water, with only a mild perineal graze (on the episiotomy scar), the third baby was born at home in water resulting in an intact perineum! (And he wasn’t a small bub, 9lb 6 oz!!)