As a Doula and a Childbirth Educator, I often hear birthing parents express their concern over tearing or being cut "down there". I wish I could tell them not to worry and say it rarely happens. The reality, however, is that many first time birthing parents will experience some tearing in the perineum during the pushing stage. The good news is that there is something you can do to reduce tearing or the need for an episiotomy. That something is "Perineal Massage".
Perineal Massage is basically the stretching or toning of the muscle surrounding the vaginal opening. It is suggested that when the perineal muscle is worked in this manner in the weeks before birth, it will make the perineum more pliable and stretchy for the pushing stage and birthing baby's head and shoulders.
According to evidence, perineal massage, when done starting at 35 weeks gestation, 2 times per week, was associated with an overall "reduction in the incidence of trauma requiring suturing...and women practicing perineal massage were less likely to have an episiotomy." This evidence was specifically significant for first time birthing parents.
Perineal massage isn't complicated. It can be done by the birthing parent on their own or by their partner. If the partner does assist, it can be a nice way to keep connected as a couple in the final stages of pregnancy.
Here's how to do it...
-Get comfortable and positioned so your legs and your back are supported and you or your partner has access to your perineum.
-Use a water-soluble lubricant or an edible oil such as coconut or olive oil on your fingers. Using something like petroleum jelly or non-water soluble cream can be drying and give you the opposite effect you are hoping for.
-Place your finger or thumb in the vaginal opening up to the knuckle at bottom of the opening.
-With a gentle stretch, sweep halfway up one side of the vaginal opening, then back down to the bottom. Repeat on the other side and back down.
-Continue doing this for approximately 5 minutes and then stop.
-Repeat for a minimum of two times per week until labor starts.
-And as is comfortable for the birthing parent, gently and gradually increase the pressure of the sweep as you approach your due date.
Perineal massage may not be comfortable for all birthing parents, and it shouldn't feel like a chore when it is done. But if done gently and over the course of a few weeks prior to giving birth, it can help make you feel like you are not just waiting around for labor to start and as we can see, it can definitely help reduce tearing or the need for an episiotomy. So why not give it a try?