parineal massage

[mel]

What is everyone's opinion on perineal massage? Is it worth it? Does it truely help? ETC! Thanks!

[mom at home]

My midwife is a true believer in perineal massage and so am I now that she attended the homebirths of both of my kids. She uses olive oil or any other good oil and massaged most all of the time I was pushing, which was a long time for my births. I didn't tear with either and my second was a big girl with BIG shoulders that got stuck. When I interviewed her when I was looking for a midwife and asked what her tear rate was, she said almost never. I now know it was because of the massage. My sister is a midwife and she does not do much perineal massage and I know her tear rate is higher. I think it makes a big difference. She also recommended that I not use soap on my perineum for the last 6 weeks of preg so that the natural oils are not washed away and dried out. I think this may have helped as well.

[Kim]

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[willibug]

I have given birth 3 times, and I have done perineal masssage before each birth. Two times I tore, and once I did not. The two tears I had weren't that bad. Once I had stitches, and once I did not. Whether or not the massage prevents a tear, it will probably aid your healing after the birth.

[LdyBluNH@aol]

my understanding from when i was preg. (back in 98) was that vit e oil was suggested for the massage as it helped with elasticity

i suppose if youre going to use epo (evening primrose oil) late in your pregnancy, it could be used for the massage as well


i tore during delivery and am not pleased with the way i was stitched up, i think the repair reduced the vaginal opening. i called the ob/midwife office about six or nine months postpartum and she basically told me to do the massage to help stretch the scar tissue.

[2J'smom]

worked for me

My husband did the perineal massage for me before birth #1. It was hilarious -we were howling- made me swear not to tell. OOps
I had two sutures and my son was transverse which means his shoulders both came out at once.My midwife said I probably wouldn't have tore at all otherwise.
I did not do any for ds#2 and didn't tear at all.
We used Olive oil for the massage and I feel it really helped. DH said he could tell the difference after about 3 messages.
I also took Evening primrose in the last 3 months of each pregnancy.
I say do it - it certainly won't hurt.

[Pallas]

special circumstances ...

we did the massage, but I tore anyway. however, I attribute it to the fact that Cub INSISTED on coming out elbow first. my middie would gently (well, as gently as possible, you know how it is) push the arm down. he would poke it back up. she would shift it over. he would poke it back up. then I pushed at JUST the wrong time and ... still, only a second degree, not so bad. kept me in bed, when I would have been up & doing WAY to soon otherwise. I had SO much energy afterwards, but I'd swing my legs over the edge of the bed to sit up and say "OOOOOOOOOH yeah, had a baby, must be gentle with those stitches!"

So, my totally unsubstantiated unscientific opinion is that the massage was more for my brain than my perenium. I'm sure the oils did some good, but mostly I was learning not to fight when I felt that stretching. it's hard to relax at that moment unless you've practiced under similar circumstances.

I'm quite sure I'd have torn much worse without the massage, and quite sure that I wouldn't have torn at all if Cub had been more cooperative or if I hadn't pushed Right Then. Lots of chance involved there. may chance be on your side!

[Katrina]

I didn't do any perineal massage until I was about to give birth- when the head was almost out. My mom and husband said that they could see it stretching as she did it, and it definitely kept me from tearing. I definitely recommend it- I felt great right after birth. I didn't even consider taking tylenol afterwards, didn't need it a bit. No doughnut pillows for me!

[tracijean]

I did perineal massage and I had to have a c-section. Go figure.

[cottonwood]

I'll warn you right off, I have a very bad attitude about perineal massage.

It's my opinion that with warmth, privacy, patience, and giving oneself over totally to the process, the perineum will stretch as much as it needs to, and that it is exposure to the (relatively) cool drying air, and inhibition and discomfort, and being coached (which keeps one from going within), that makes tears more likely.
All of these things go along with perineal massage.

In my case, I had it done with my first. It was terribly painful, first of all, to have to be on my back, and pushing was difficult that way. Second, it was disconcerting to have someone down there working away on me. I could not seem to focus on anything but the pain and the fact that my perineum was the focus for everyone else in the room. I believe that my inhibition and being constantly pulled back into the reality of my attendants by their actions both hindered the baby's progress and the ability of my body to respond appropriately to the baby's movement through me. I don't think my body was ready to give birth, yet the forced pushing and stretching of my perineum hastened the birth unnaturally, so my perineum wasn't naturally and fully ready by the time the baby came out. I did not tear, but I did have a "skid mark" that burned every time I urinated for several days, and my perineum felt bruised and swollen for days as well.

For my second and third births, no one was allowed to touch my perineum. Because I was laboring either in water or in an upright position either with my legs together or sitting on something, my perineum stayed warm and moist, and probably most important, much more relaxed than if someone I was not normally intimate with was touching it. (Not only touching, but stretching and manipulating. Not pleasant.) Without the observation and physical intrusiveness I was able to go "within" and listen to what my body needed me to do. The babies slid out quickly and easily (one even had a nuchal hand), and I had no trauma to my perineum.

I know others have had a different experience with perineal massage, even enjoying it. But I consider it an intervention, one that carries risks. I can't say that it is a bad thing for all people, but I do believe it is at best physiologically unnecessary (mentally, of course, *believing* that something will help may in itself have a positive effect,) and at worst can actually hinder and hurt.

[mel]

You have all been so helpful! I love reading each and every story/opinion - I haven't discounted a one of them! Thank you~Mel
p.s. I'll continue to read any other posts anyone would like to add yet

[Eman'smom]

The midwife did massage during the last 10 minutes of pushing, I didn't tear. She said not to bother pre-labor with massage, that there was no way to accomodate for the head anyway.
I pushed when I had the urge so I was slowly streaching anyway.

[candiland]

There seems to be some confusion about which type of perenial massage Mel is talking about. Some are talking about the perenial massage you do in the last trimester once or twice a day to stretch the vaginal outlet; others are talking about the massage once they were already in labor. I did not do perenial massage on myself; however, when I was pushing (which was for 3 1/2 hours) my midwife did some gentle massaging and stretching with olive oil. I was NOT flat on my back. She did it on the birth stool, in the squat, on the bed, whichever position I wanted to be in.... to be honest, I didn't even notice her doing it, I was focusing so much on pushing. I think massage during the last trimester is a bonus, because it has been shown to increase circulation and elasticity. It also helps some ladies get in touch with their vaginas - so much of it may be mind over matter. Who knows? I plan to start doing massage now that I have two months to go.... I figure, I know it won't hurt, and it just might help!

[crowbaby]

I experienced both kinds of pereineal massage and I think they both helped in their own way.

My dh used olive oil and steched the vaginal opening probably about 5 times in the last trimester. I think the greatest thing about it was having to relax through it. It really allowed me to practice my Bradley training! It is not painful but boy is it uncomfortable.

My midwife massaged my perenium during the birth with oil and hot compresses. I think it helped because I didn't tear at all. However, I also understand what sweetwater is saying and I might want to be left alone for the next birth...I was almost panicked to get the baby out by the time I was pushing that I didn't really feel good about the whole 2nd stage of labor. Would it have been different if I had been left alone. Who knows. Next baby maybe we will experiment...

Karen

[Nankay]

Hi, we did the massage throughout both pregnancies and during birth. My midwife had a little crock pot full of warm water and wash cloths which she applied through labor and pushing--yum. A smart aleck doc came in to observe a midwife in action and asked why she was making soup. LOL By the way..I didn't tear with either birth.

[Serenity]

Thought you all might find this article of interest. It is a study published in 2001, the first to examine if perineal massage during second stage labor helped prevent tears. The article says that perineal massage during pregnancy has a slightly beneficial effect on reducing tearing during second stage but perineal massage during second stage had no effect. (although they say it doesn't hurt). Here's the link:

http://bmj.com/cgi/content/full/322/...&pmid=11375230

[Treemore]

Hey Mel! I love the crock pot with warm washcloths idea, I could do that for you if your midwives don't think of it first.

To you ladies who may be wondering, I am Mel's sister and will be with her when she has Jr. She is huge and looks like she is going to explode. I can't wait to meet my new neice or nephew!!

[kama'aina mama]

My midwife massaged my perineum while I was pushing. I found it uncomfortable. It may have helped though, I had one tiny tear that healed just fine on it's own. The warm washcloth was amazing though. If she held it in place while the baby was crowning it totaly stopped the 'ring of fire' feeling. Halleluia!

I was shown something the other day that makes me think the position of your legs may have a ton to do with tearing. High, but sort of narrow, knees pointing towards your ears is great. If you go real wide you are stretching the perineum taut from the sides, which makes it vulnerable.

Mel you are so lucky to have a sis nearbye who will help you out! Good luck!

[laralou]

I told this on another thread but it was one of the few things I was knowledgable about and insisted on despite being in a medicaid clinic. They respected my wishes. A really nice nurse did it and I felt no pain at all. I had no muscle tear at all. I only had light skin tears which had healed within the week.

[AMum]

My dh did perineal massage for me during my last trimester with ds & the midwife massaged during pushing. I did not tear even though ds was 9lbs. posterior occipital with his hand up on his cheeck. I think it works. But I don't see the point in doing anything that makes the mom uncomfortable. I am planning a water birth this time around & dh & I don't have the privacy for perineal massage . Not something I want to do in front of my 3 year old, even though he will be at the birth.