Feeling nervous about perineum...

[sarahwg]

My midwife suggested I do the perineum massage. His reasoning was that he wanted to be able to let me be free to get into any position I wanted to labor and if I got into a position where he didn't have access to my perineum there was a bit of insurance b/c I will have massaged the area. But....I just wasn't motivated to do it. I had no ripping or tearing with my son so I guess I just didn't see the necessity and I just wasn't finding moments...blah blah blah...I only did a few times.

But now I am kinda worried and I don't want my fear of tearing to impede my labor...I am wondering if it is worth it to even begin it now at 40w2d? I know it is controversial and midwives should be able to support your perineum during labor to minimize the risk but what if I do choose a position that doesn't provide good access...yikes.

I am crossing my fingers that this baby comes slow enough to allow my body to naturally stretch or that I am numbed from feeling the pain or that my MW can support me...

Any thoughts? Words of encouragement?

P.S. Does birthing on all 4's minimize the risk of tearing? I just watched orgasmic births as well as loads of other births on youtube and being on all 4's seems to be a common choice for women...of course I realize I have no idea what I will feel like in the moment.

[because]

nak

I never did PM and have never torn, even with freakishly fast deliveries with #2 and #3.

If you're in a position that makes it hard for your attendant to support you, you may be able to support yourself (and will probably naturally do it if you are uninhibited).

I would find a way to release that fear and then do PM only if you feel like it.

[ktmama]

Some things that helped me:
1. Being on hands and knees for dd2, kneeling for ds1.
2. Having my partner support my perineum during both births' pushing stages.
3. Having him pour olive oil on my perineum - ahhhhhh!
4. Warm compresses.

I never did massage and I've never even had a skid mark - one looooooong labor/pushing and two relatively fast ones. If I were you I would follow my instincts and just be ready to support your own perineum if your m/w can't get there. Good luck!

[erin_brycesmom]

I don't think it is worth it at all, ever. The evidence is really weak and the only possible benefit is shown for first time moms but I doubt it even helps them. I also don't believe that midwives should support the perineum either. I don't think it helps to have anyone else's hands on your perineum except your own and maybe your SO. Check out this article and it should relieve some of your fears - http://www.midwiferytoday.com/articles/honoring.asp

[sarahwg]

Great feedback ladies!!:

I hadn't even thought about supporting my own perineum during labor....duh! I am not inhibited by any means so this makes a lot of sense to me. I really think everything is going to be awesome and great it just seems that everyday that this babe doesn't arrive gives me a touch more worry about labor. My motivation and excitement is impacted by the realization that it really is going to be happen any day now...

Off to read the article now and again thank-you for your comments...I really feel much better after reading them!

[midnightmommy]

I was nervous about tearing before labor, but at the point of actual birth that was my last thought. I had a couple first degree tears this time, but I didn't really feel them tear. I did feel the periurethral tear, but it actually felt really good when it gave way and her head came out. Afterward I was sore for a couple of days. I just made sure I wasn't stingy with the ice pacs and took some motrin. By day three I was feeling pretty good. BTW...neither of my kids had cone heads. They both were born with perfectly round heads. Might be why they tried to stretch mommy out so much.

The moral of the story is that most tears are not that big of a deal. Not tearing at all would be best, but don't fear if you do. You'll be tender for awhile but it will be ok.

[Youngfrankenstein]

I never did PM with any of the 3 I had. Don't worry, I felt guilty about not doing it!

I had 2 stitches with 2 of them but that was nothing. I healed like a champ. One of those babes was 10# and had shoulder dystocia.

I think they body adapts to what it needs to do.

Or as they said on "Baby Mama": "Can't I just spray some Pam down there when the time comes?"