> perineal tearing, massage and stretch marks: oh, my!
I got some great info from my midwife, and I thought that I would share it here:
We were talking about perineal massage, and my midwife advised me that practicing daily perineal massage is shown to reduce the risk of tearing, whereas perineal massage after you are in labor is not really shown to help as much.
I asked her whether she thought that there might be some correlation between many, many stretch mark and perineal tearing. She said that, indeed, a study done in recent years by midwives in Greenland showed that women who had fewer strech marks were less likely to have perineal tears. Their hypothesis was that such women had greater elasticity in their skin and could endure the stretching in both areas better than women who had lots of stretch marks and perineal tearing.
She also noted that nutrition (lifelong) was a factor in this study, as well.
My experience didn't hold true with that hypothesis though, so I'd thought I'd share my take on it. My first pregnancy I was one huge stretch mark, from my breasts all the way down to my knees, stretch marks everywhere! I was SO upset. My diet at that time was total crud too, mostly fast food, I gained 42 pounds. I was 19 years old. My labor was induced, medicated and I delivered in the lithotomy position. I only had a tiny tear, "not worth stitching". The nurse had done what I consider a very rough form of per. massage, basically sticking two fingers in me while I pushed and massaging back and forth. Maybe it helped stretch that skin, I dunno. My second pregnancy, I was vegan, drank flax oil every day, exercised, was generally much more healthy, age 23, and I gained 43 pounds. I had less stetch marks than last time but still quite a bit. I labored in water and Kai was born very quickly after I stepped out of the tub. Again a "not worth stitching" tear. My very long rambly point is that for me stretch marks did not equal tearing, if that's of any use to anybody. Thanks for letting me yap about myself!
Slightly off topic...my mom was right next to me as I gave birth to Jake. She told me that my OB walked in and immediately picked up what looked like scissors and then walked over to watch me push. He kept them behind his back for a few pushing contractions. He apparently decided that I wasn't going to tear and put them down. So...I guess I came *this* close to an episotomy.
I learned the same thing in doula training last weekend. The best way to prevent perineal tearing is with massage from 36 weeks onward. Doing in labor doesn't seem to make a difference in who tears and who doesn't tear.
I agree that perineal massage in labor doesn't help, and I would add that it can even *harm* if it is uncomfortable, annoying, or inhibiting for the mother.
That is so interesting about the stretch marks/diet hypothesis. I have negligible stretch marks, and my diet is good, but not fantastic, and I have never torn.
I would think hydration, position during labor, and breathing the baby out as opposed to forced pushing would all be factors as well...
With my 1st pregnancy, I had no stretch marks and did do peri. massage during the last few weeks of pregnancy. Unfortuntely, I did have to have an epis. due to fetal distress. The midwife did say that I was stretching just fine though.
This time, so far no stretch marks (I'm at 36 wks.), but I haven't done any peri. massage this time. My birthmom didn't get any stretch marks w/any of her pregnancies, but I don't know about tearing.
Funny I read the complete opposite somewhere.. that pernieal massage during pregnancy did little and that pernieal massage and support during labor was beneficial.
As far as stretch marks go, everything I've read attributes their occurance to genetic factors of skin elasticity and hydration.
Not sure what this means, but my expirience was no massage during pregnancy only during labor. I had no stretch marks until I reached the middle of my 38th week. I ended up with a 2nd degree tear, which hasn't caused me really discomfort at all so far. I believe my tear is mainly the result of the position I delivered in. I was not able to choose the position I'd have most prefered because the baby was thought to possibly be in distress when I positioned myself in certain ways.
I have miles of stretch marks and never did any perineal massage--not a tear on either of my kids.
Stretch marks are genetic and have to do with deep layers of skin tissue. It seems to me that the skin on the vagina is thinner and much different.
Maybe its true but not for me.
My midwives say that perineal massage is helpful insofar as it helps you experience the sensation of stretching, so you recognize it and don't tense up (and hence, tear) during crowning. Makes sense to me!
I have tons of gorgeous stretch marks, but I would be delighted not to tear!!
Yeah, I just have to chime in that I got *tons* of stretch marks with Xiola and did not tear at all. I never did any perineal massage but I did stay sexually active nearly to the end of the pregnancy (more fun then perineal massage if you ask me
) and my care provider did support my perineum while I was pushing. I also was taking EFA's so I would think that helped me be extra-stretchy as well.
There are *so* many variables involved (nutrition, genetics, care provider attending your labor, etc) that it would be hard to say exactly *what* makes or breaks something as important as wether or not a mama tears. But I still think that it's worth talking about those factors so we can be aware of them and each do what works for us to help prevent them.
|Originally posted by XM
never did any perineal massage but I did stay sexually active nearly to the end of the pregnancy (more fun then perineal massage if you ask me ) XM
This is news to me! (good news, ha ha!)
It makes sense that sex would help like perineal massage. DH will be thrilled to learn that he is helping me not to tear!
hee hee hee.
Ahh, stretch marks! I never thought I'd get them and then my Mom mentioned how she stretched everywhere, even the armpits! I'm slathering on Burt's Bees Decollete cream, supposedly it works on old marks so I'm hoping it stops any new ones too! Good luck!
I'm practicing the "alternative" to perineal massage, my DH will be happy to know that he is helping the cause!