Many women fear the possibility of tearing and having an episiotomy [cut to enlarge the vaginal opening during birth] and opt for an unnecessary caesarean section because of the fear of vaginal trauma and possible sexual dysfunction later in life.
Prenatal perineal massage is the gentle massaging and stretching of the skin between the anus and the vagina [called the perineum], during the last weeks of pregnancy. Perineal massage appears to be more effective from 34 weeks of pregnancy.
For many years, experienced midwives had massaged the perineum during the second stage of labour [birth of the baby] with great success, to prevent tearing, and allow stretching of the vagina. In addition to perineal massage, a slow gentle delivery will help to avoid perineal trauma.
Perineal massage has been shown effective in preventing the need for episiotomy and a decrease in the amount of tearing a woman has during her birth.
Progesterone and Relaxin hormones soften the muscles and ligaments to allow stretching and the pelvic floor and the perineum are no exception.
Perineal massage is particularly effective in women oven the age of 20. Massage should be done gently to avoid trauma to the perineum or upsetting the mom.
Other benefits include:
Although the perceived benefits of an episiotomy had long been disproven, some midwives and obstetricians still routinely perform one.
It is a good idea to have this intimate conversation with your caregiver during an antenatal consultation. This is little evidence that support a routine episiotomy.
Perineal massage should be avoided when you have an active sexually transmitted disease, herpes, thrush, or any other vaginal infection, because the risk of spreading the infection and worsening of the condition. It can be done again once the infection was adequately treated.
Use a lubricant like vitamin E oil, almond oil, or olive oil. All the following can be used during perineal massage, to act as a lubricant:
A petroleum-based oil should not be used to avoid damage to the vaginal mucosa.
Researchers differ in their opinion on the length and timing of the massage, but if done daily, it may help you to set into a routine more easily.
The massage need not be long, 2-4 minutes 3-4 times a week or even daily, as the mood dictates.