In week 34 it’s worth preparing your perineum for delivery. This seems to be particularly true for first time mothers over the age of 30 or for women who have not experienced tears or episiotomies in previous deliveries. Fans of perineal massage also believe, regardless of how many babies you have had, that massage helps you cope with the stinging sensation as your baby’s head crowns and helps familiarize you with the stretching sensations of delivery so you can more easily relax these muscles

Frank Anderson, MD, MPH, an assistant professor of Obstetrics and Gynecology at the University of Michigan Medical School writes, “In multiparous women who have had previous episiotomies, the perineum contains scar tissue that is weaker than normal tissue, so the perineum will be more likely to tear at subsequent deliveries and will be less likely to respond to massage.” Perineal massage also seems more helpful to first-time moms over the age of 30, says Dr. Anderson, noting that this could be due to older tissues being stiffer than younger tissues.

The perineum is the area of skin between your vagina and rectum. On the whole, you should steer away form perineal massage if you have an active vaginal infection or herpes lesions, history of preterm labor, premature rupture of membranes, if the massage induces contractions, or even if the procedure simply makes her sore or uncomfortable (www.babyzone.com).

Peg Plumbo, CNM, a certified nurse-midwife and instructor at the University of Minnesota School of Nursing writes, “If you do try perineal massage, keep in mind that birth is unpredictable by nature. Tears do often happen, and episiotomies sometimes become necessary, even during highly prepared-for births.” She also says, “Perineal integrity has more to do with race, parity, age, and overall state of health than it does to perineal massage.”

The University of Michigan has an interesting project called PERL (Protecting Effective Recovery from Labor) where they advocate perineal massage. If you go to this page and scroll down, you will see a graphic that shows how you actually perform perineal massage. I found it very helpful…..

http://www.umich.edu/~umperl/massage.htm

I am also including their instructions for performing perineal massage

- Sit or lean back in a comfortable position. (A warm bath or warm compresses on the perineum for 10 minutes before massage may help you relax.) If not, make sure you have thoroughly scrubbed your hands beforehand and trimmed your nails.

- Put a water soluble lubricant such as KY Jelly, or a vegetable based oil such as olive oil Vit. E oil or in Ayurveda they recommend organic sesame oil on your thumbs and perineum.

- Place your thumbs 1 to 1 inches inside your vagina.

- Press downward towards the rectum and to the sides at the same time until a slight burning, stinging, or tingling sensation is felt

- Hold the pressure for 2 minutes until the area becomes numb.

- Breathe deeply and slowly and try to consciously relax the muscles.

- Keep pressing down with your thumbs and slowly and gently massage back and forth over the sides of your vagina in a U movement for 3 minutes.

- Relax and repeat once.

This massage technique is performed 10 minutes daily beginning at week 34.

Email This Post - Subscribe to this feed - Save to del.icio.us -
December 27th, 2006 | Permalink