Prenatal Perineal Massage to lower Tearing

 

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Prenatal perineal massage has been shown effective in preventing the need for an episiotomy and a decrease in the amount of tearing a woman has during her birth. This is particularly effective in women over the age of 20 and in women having their first baby. This technique is used to help stretch and prepare the skin of the perineum for birth. Perineal Massage During Pregnancy Helps Prevent Tearing During Delivery When it comes to perineal massage, this old saying definitely applies: An ounce of prevention is worth a pound of cure.

Perineal massage during pregnancy involves the gentle, manual stretching of the tissues that shape the birth canal. Massage increases blood flow and may help the tissues and skin stretch with more ease but with less pain during childbirth. Lowers risk of tearing.

Around 1 in 15 women who regularly do perineal. “Beckmann and Garrett found that women who were randomly assigned to do perineal massage had a 10% decrease in the risk of tears that required stitches (aka ‘perineal trauma’), and a 16% decrease in the risk of episiotomy. For expecting mothers For pregnant mamas, there are no negative effects and perineal massage during childbirth has been shown to decrease severity of vaginal tearing. Start around 34-35 weeks and learn how to properly bear down during childbirth to ensure pelvic floor muscle relaxation.

During pregnancy, massage of the perineum can reduce the risk of tearing requiring stitches, but this benefit is only seen in moms giving birth vaginally for the first time. It is thought that most of the decreased risk of perineal trauma was due to a decrease in the episiotomy rate. Starting at around 34 weeks of pregnancy, take the following steps to try perineal massage at home: Wash your hands thoroughly and be sure your nails are clipped. Sit in relaxed position with your head supported on a bed and your knees spread wide.

Apply a. The most common use of perineal massage is during pregnancy. During the last 4-6 weeks of pregnancy many care providers encourage women to massage their perineums at home: 2-3 times per week; 3-5 minutes per session; alone or with a spouse/partner; Women are told that by doing perineal massage at home they will experience less tearing during childbirth. Perineal massage tips. Warm bath.

Sit in a warm bath before you start. This may help you to relax before the massage and loosen the muscles around your perineum. Short nails.

The tissues in your vagina and perineum are very delicate. Make sure your nails are short to prevent scratching the skin, or. Perineal massage.

During the second stage of labor, your health care provider might place two fingers of a lubricated gloved hand just inside your vagina and move them from side to side, exerting mild, downward pressure.

List of related literature:

This may include the application of pressure to the area, or perineal massage to help facilitate the stretch of the tissues and minimise tearing.

“Pregnancy and Childbirth E-Book: A holistic approach to massage and bodywork” by Suzanne Yates
from Pregnancy and Childbirth E-Book: A holistic approach to massage and bodywork
by Suzanne Yates
Elsevier Health Sciences, 2010

Vaginal and perineal tears may be avoided by perineal massage and stretching exercises before delivery.

“Swanson's Family Medicine Review E-Book” by Alfred F. Tallia, Joseph E. Scherger, Nancy Dickey
from Swanson’s Family Medicine Review E-Book
by Alfred F. Tallia, Joseph E. Scherger, Nancy Dickey
Elsevier Health Sciences, 2016

Perineal massage in the third trimester reduces the incidence of perineal trauma in primiparous but not multiparous patients.

“Oxford Textbook of Primary Medical Care” by Roger Jones (Prof.)
from Oxford Textbook of Primary Medical Care
by Roger Jones (Prof.)
Oxford University Press, 2005

This reflected differing philosophies among midwives, and did not seem to affect the overall rate of tearing.

“Birth Models That Work” by Robbie E. Davis-Floyd, Lesley Barclay, Jan Tritten, Betty-Anne Daviss
from Birth Models That Work
by Robbie E. Davis-Floyd, Lesley Barclay, et. al.
University of California Press, 2009

(Among more experienced mamas, regular massage doesn’t seem to have much effect on tearing, but it is associated with less perineal pain in the months following delivery.)

“The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth” by Genevieve Howland
from The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth
by Genevieve Howland
Gallery Books, 2017

Prenatal perineal massage can reduce the need for an episiotomy (a surgical incision to enlarge the vagina, done just before the birth), and reduces the likelihood that the mother’s tissues will spontaneously tear during birth.

“The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth” by Penny Simkin
from The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth
by Penny Simkin
Harvard Common Press, 2001

During the pushing phase, your practitioner will probably use perineal support – applying gentle counterpressure to the perineum so your baby’s head doesn’t push out too quickly and cause an unnecessary tear.

“What to Expect When You're Expecting 4th Edition” by Heidi Murkoff, Sharon Mazel
from What to Expect When You’re Expecting 4th Edition
by Heidi Murkoff, Sharon Mazel
Simon & Schuster UK, 2010

Prenatal perineal massage on a near‐daily basis beginning at 35 weeks is associ­ated with a decrease in perineal damage requiring repair with suture.21,22 Women or their intimate partners can perform antenatal perineal massage (as long as there is no vaginal irritation or tissue breakdown).

“The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia” by Penny Simkin, Lisa Hanson, Ruth Ancheta
from The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia
by Penny Simkin, Lisa Hanson, Ruth Ancheta
Wiley, 2017

In addition, perineal massage during the final 6 weeks of pregnancy may decrease perineal trauma.

“Maternal Child Nursing Care E-Book” by Shannon E. Perry, Marilyn J. Hockenberry, Kathryn Rhodes Alden, Deitra Leonard Lowdermilk, Mary Catherine Cashion, David Wilson
from Maternal Child Nursing Care E-Book
by Shannon E. Perry, Marilyn J. Hockenberry, et. al.
Elsevier Health Sciences, 2017

Massaging with oil helps the perineal tissues to soften and thereby gently unfold with no resistance as they open during birthing to allow the passage of the baby.

“HypnoBirthing, Fourth Edition: The Natural Approach to Safer, Easier, More Comfortable Birthing The Mongan Method, 4th Edition” by Marie Mongan
from HypnoBirthing, Fourth Edition: The Natural Approach to Safer, Easier, More Comfortable Birthing The Mongan Method, 4th Edition
by Marie Mongan
Health Communications, Incorporated, 2015

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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13 comments

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  • I had a friend sit in panty liners with aloe vera gel starting her 3rd trimester. Keeping the skin hydrated helps it stretch better without tearing. She tore on the inside not the outside.

  • Do it have to be a certain type of cocnut oil or can it be any kind??

    Because I didnt see that in wal mart. Not big fan of ordering stuff online.

  • lol im not trying to be funny but when you said use your two fingers and rub your perineal massage…did u really mean masturbation? lol������

  • This is great, but just to clarify, NHS in the UK actively discourage daily massage. They advise massage 2-3 times per week will provide the same results, without risking damaging the sensitive tissue down there…

  • I tore good. Had an epidural. But I think it was the doctors fault. Because she pulled my son out at the shoulders. And that’s when I tore.

  • Thanks for sharing this, 25 weeks and scared about labour (baby number 2) but I did tear and have a long labour last time. Thanks for the advice

  • Thank you for making this video! Currently 35 weeks and have been doing massage for a couple weeks now. There is definitely a progression and if anything makes me more comfortable, relaxed and confident that I can do this!

  • Vitamin C in high amounts isn’t bad for pregnancy as most people would read on the internet. In fact, as vitamin C is a precursor to collagen, it helps to prevent stretch marks AND in a study where women took high amounts of vitamin C had great help for stretching the perineum, and easier labor.

  • Can someone show the positions she is talking about that are best? The upright, upright squatting. I am giving birth in a hospital so know the common back lying positive.

  • I did the massages probably 6 weeks before my first child was due, had an epidural and I had no tears at all. I felt so lucky. This child will probably be on the bigger side and my only fear once again is worrying about tearing. But I swear by the messages so we will find out soon. ����

  • Hi Sarah! Thank you so much for educating us. I’m in week 22 of my first pregnancy. I was wondering if you have any experience/knowledge or opinions (and not medical advice) with women birthing naturally that have a history of cerebral aneurisms. I have had two craniotomies, one to clip a burst sub-arachnoid haemorrhage and a second to clip one that hadn’t burst. My last MRI scan was in 2012, it showed no sign of any further blebs/aneurisms, and I have completely changed my lifestyle since then. I remember being told explicitly that I would need a c-section if I were ever to have a baby, but I really want a natural home birth. I am yet to find anyone who would take on the responsibility of assisting me with home birth. There is also only one study that I’ve found online regarding this, but it is a study that was conducted in a hospital. There were no infant/child mortalities in women with a history of haemorrhage prior to pregnancy with assisted birth (forceps/suction) in stage 2 of labour. This is not what I want though anyway. With Covid and the second wave estimated to be around the time I’m due, more than likely my partner would not allowed to be present for a hospital birth.
    Once again, thank you for your time, sharing your knowledge and expertise with passion and humour. ❤️

  • 1:19
    Jeeez look at the size of that vagina. My wife’s was hurting at the size of a 50p piece. Are you mental? Noones vagina is stretching that much with a couple of thumbs surely. Why can’t I find an actual real video of a perineal massage…so many contradicting tutorials it’s impossible to know I’m doing anything of benefit

  • I’m hungarian. That’s very interesting I wanted to know everything. In my country 90% has episotomy. Thanks for the explanition