Thursday, February 21, 2013

Labour: Perineal Massage

I was doing some reading on birth plans and also stumbled on this term in babycenter's e-mail to me. In fact, knowing this helps as the midwife in my antenatal class also recommended doing perineal massage to prevent tearing (no guarantee or proven research it works - but no harm trying).

Basically, you need to understand the term "tearing", "episiotomy" and "perineal massage" in this post.

In layman's term, for natural birth, your baby needs to come out through your vagina and your vagina will expand to accommodate it. Some mothers opt for natural birth - meaning the vagina might tear during the pushing.

Some mothers opt for episiotomy which is a surgical cut to the perineum to allow your baby to come out and avoid tearing.

Personally, I thought it is not advisable for episiotomy due to stitching and maybe slower recovery but after asking around, apparently it is the same. But my doctor seemed confident that episiotomy is not needed and I've seen that specifically mentioned in a few birth plans I have obtained.

What is "Perineal Massage"?
(taken from

Some practitioners recommend massaging the perineum (the area between your vulva and your anus) to help you avoid having an episiotomy or tearing during childbirth. Not everyone is comfortable doing this but if you'd like to give it a try, now's the time to start. 

How to do it?

Here's one method: 
 • Wash your hands and then sit in a warm, comfortable area, spreading your legs apart in a semi-reclined position. Put vitamin E oil (from vitamin E capsules) or pure vegetable oil on your fingers and thumbs and around your perineum.

 • Place your thumbs about 1 to 1 1/2 inches (up to or just past your first knuckle) inside your vagina. Press down toward your rectum and then out toward the sides. Gently and firmly continue stretching until you feel a slight burn or tingling. Hold this stretch for about 2 minutes – until the tingling starts to subside. 

• Slowly and gently massage the lower part of the vaginal canal back and forth, hooking your thumbs onto the sides of the vaginal canal and gently pulling these tissues forward, as your baby's head will do during delivery. Keep this up for 3 to 4 minutes.

 • Be gentle, as a vigorous touch could cause bruising or swelling in these sensitive tissues. During the massage avoid pressure on the urethra (urinary opening). This can cause irritation or infection. 

Other options
Besides this, my Obgyn also recommend having sex often to soften the perineal area. My husband got annoyed when I asked him directly to have sex just for this reason... .lol

Postpartum perineal care

Babycenter has a list of to-do and advice on how to care for your perineal area.
But I've prepared 2 things for this too.
1. Epsom salt (below RM5 from pharmacy) to be soaked in a basin for your bottom. Apparently it will soothe the pain. Do this by making a sitz bath. (haven't checked out on the sitz bath but thought a basin should do?)

Twenty-four hours after you give birth, you can start taking warm soaks in the tub or in a sitz bath for 20 minutes three times a day. A sitz bath is a shallow plastic basin that you fill with warm water and position over your toilet seat. It makes it convenient to soak your perineal area several times a day without having to fill a tub and completely undress each time. Most hospitals will provide you with a sitz bath to use while you're there, and it's a good idea to take it home with you. Sitz baths are also available at most drugstore.

2. New Mama Bottom Spray - this is highly raved by mummies to with the same effect as above. :) Spray directly to your perineal area to soothe the pain.

Wish me luck that I'll have a smooth natural delivery (which could be anytime now!!)  and speedy recovery! :)

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