Perineum Massage: Decrease Chance of Episiotomy

on September 25, 2009 at 7:00 AM

perineum massage In all my readings about labor and delivery there is one word that continues to stand out and totally freak me out -- EPISIOTOMY.

I cower in fear to that word.

An episiotomy is an incision made to the perineum to make the vaginal opening larger for the baby to fit through. Some women tear during birth as well.

Yes, I know, if I was to have an episiotomy, I wouldn't feel it thanks to numbing agents, but still -- cutting? My vagina! Oh my gosh I may just have to stop writing this post for a moment so I can calm down....

OK, I'm back. Shaking it off. Here's my good news: There are massages my husband can do to my perineum to prepare my area for birth. It helps make it more able to stretch without tearing. Like an athlete preparing for a big game or marathon, I'm prepping for my big event. Twins!

And doesn't it sounds kind of sexy? Kind of. I haven't seen my vagina lately since my belly is so big so I am a bit overgrown. So it's 70s style sexy, I guess. I can do it to myself, by why not let hubs do it? Thankfully, he's the one who read about it in The Birth Partner, so he's all for it.

So how do you do it?

Start with super clean hands, of course. And trim nails.
The mother should be comfortable in a semi-sitting position with legs bent and relaxed
Find your perineum -- the skin between your vagina and your anus.
Lube fingers with oil of your choice. No baby oil, mineral oil, or petroleum jelly. Some say extra virgin olive oil. (Or EVOO -- do you watch Rachael Ray? Have you seen Baby Mama? If so this may be funny to you.) You can also use a lubricant like vitamin E, wheat-germ oil, or a natural feminine lube.
Start with one finger and place in vagina to knuckle.
Bend finger slightly and gently apply pressure downward toward anus and outward...in the direction the baby will be descending.
Maintaining pressure, rotate finger to make a "U" -- so if downward is 6 o'clock, think about rotating from 4 to 8 o'clock.
You may feel a tingling -- this is the stretch happening.
Repeat for ten minutes. Do daily, starting around your 34th week of pregnancy.
You can add fingers as the stretching progresses.

Have you tried a perineum massage? Would you?

Related posts

Perineal Massage

Did Anyone Get an Episiotomy?

Help! I'm Freaked Out About Labor & Delivery

About the author Michele Zipp

loves vintage and will defend skinny jeans to the death though she is highly superstitious and "death" is probably a bad word choice. She has a touch of the hoarding disease and enjoys sleuthing, the worst reality shows, and wearing high heels, even at the playground. She's an AP mom of twins, slightly crunchy but with a pedicure.

Filed Under: baby prep, delivery, labor & delivery

Comments (15)

sodapple

on Sep 25, 2009 at 9:20 AM

like you, i'm scared of having an episiotomy, in my case it will be my first time and try, my first child was a csection so i'm getting ready to to try for a vbac and an episiotomy does not sound fun so i'll tell hubby to do some massages =-)

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sstepph

on Sep 25, 2009 at 10:01 AM

I never did that really. I did a lot of prenatal yoga and stretching which I think really helped plus I walked every single day up until I went into preterm labor at 32 weeks. I had a midwife so she didnt do a episotomy. I did tear though but only needed 3 stitches. And DS was 8lbs 2oz.. and I'm small.

Its not thaaaat bad... yeah you're sore for awhile.. even after you get the okay to have sex at your 6 week PP checkup.. it still hurts.. but it gets better after awhile. The numbing spray they give you and the sitz bath do wonders!!!

JoyandLove

on Sep 25, 2009 at 10:13 AM

I have been fortunate I have never needed an episiotomy.

DreaKevAiyana

on Sep 25, 2009 at 11:00 AM

I probably would have kicked any doctor that tried to cut me down there!! I'm glad I had a great midwife who would never do that. I tore and required two tiny stitches, but even without any drugs/numbing agents I didn't hurt at all after that.

miriamz

on Sep 25, 2009 at 12:43 PM

We learned in doula class the best way to avoid episiotomy is to use a provider who doesn't do episiotomies. With that said I did my own form of perenial massages with my third and for the first time didn't tear at all even though he was posterior and not at a good angle when he entered the birth canal.

Kimra

on Sep 25, 2009 at 1:25 PM

my hubby did perineal massage on me when i was 34 weeks up to a few days before i had my baby (i was in labor for 3 days). my midwife actually showed him how to do it properly, it was kinda awkward but WELL WORTH IT. i had a TINY tear and got ONE small stitch. also, if you practice "breathing" the baby out rather than "pushing" the baby out you won't tear as bad. I have friend who had a 10.5 lb baby and didn't tear because she used "breathing the baby down" techniques

on Sep 25, 2009 at 1:28 PM

and i'd also like to add that my SIL's husband didn't even have sex with her during her pregnancy and she TORE SO BAD...she even had an episotomy and STILL tore horribly bad. it was like a virgin pushing a baby out. i feel so bad for her "down there" parts. her postpartum was WORSE than her labor. I think sex can even help stretch that out down there and help with the tearing factor

Crystal8327

on Sep 25, 2009 at 2:32 PM

I had one and its no big deal if your doctor knows what she or he is doing in my case i had to have it my tearing would of been very extensive I am very small in that area sex has always been painful im like a virgin for life =(.

doulala

on Sep 25, 2009 at 7:40 PM

Moms~

if you don't want an episiotomy don't have one.
(*It's that simple!) ;-)

They are optional.

on Sep 25, 2009 at 7:42 PM

I really think that episiotomies don't seem justifiable. (*In VERY rare circumstances, maaaaybe.) But many doctors do/did them routinely! Some Dr.s have 30% or higher rates. The more practiced mediolateral (angled) cut increases post-partum hemmorhaging 450% and 33% for the midline (straight down) cut. It only speeds up labor a contraction or two-- not worth the many complications that are involved, like incontinence and sexual displeasure. :-(

Please know that there are ways to avoid tearing, so birthing with the perineum intact (or mostly intact) is possible.

Consider: Perineal massage/oil, kegal exercises, water labor/birth, NO coached pushing, hand on the emerging head & perineum, blowing air Os slowly, intentionally slowing down the crowning through concentration. Be sure to stay upright, move & wriggle your baby down and out. :-)

The best way to prevent tearing - Honoring Body Wisdom