As a soon to be mum, you’ll receive a lot of advice, both solicited and unsolicited. It can be overwhelming, particularly because you don’t want to ignore any tips that could help you deliver your baby safely.
In addition to the mountains of advice, you’re also probably dealing with fear. A common fear, especially among first-time moms, is that their vagina will tear while giving birth. This phenomenon is called a perineal tear. Serious cases of perineal tearing are rare but when they do occur, they might need surgery.
The less serious cases are common. Some heal on their own while others require stitches and a few weeks to heal.
In any case, it’s important to do what is best not only for the safety of your baby but also for your sake. This means taking the necessary precautions to ensure that you don’t experience any level of tearing while giving birth.
And that brings us to perineal massage. If you’ve heard of perineal tearing, you’ve probably heard that doing perineal massage before birth is one way to prevent it. In fact, most sources claim that it’s the only way. What you are not sure about is whether it really works. Let’s find out.
The Origins of Perineal Massage
Traditionally, under the supervision of midwives, pregnant women in the west have been doing perineal massage. However, it is reported that perineal massage was first done in Africa, and that it was discovered by a German doctor, who then tried it back home.
There seems to be a world of difference between the version of perineal massage done now and the one done in Africa. The African version can be more aptly referred to as Birth Canal Widening. It was done using gourds of increasing sizes, and was found to be effective.
This has evolved into a less scary sounding version. Nowadays, rather than gourds, perineal massage is done using fingers, and with the help of a range of perineal massage oils.
Why It’s Done
The primary goal of perineal massage is to reduce the amount of strain that the baby goes through in the final thirty minutes of labor. It’s also done to prevent vaginal tearing and to eliminate the need for an episiotomy, which permanently damages the pelvic floor muscles. An episiotomy is when the delivering physician makes an incision in the perineum to provide more space for the baby to come out.
An episiotomy involves cutting through the nerves that lead to the pelvic floor, which increases the probability of the mother developing a prolapse in the future.
How it Works
Perineal massage makes the area between the vagina and the anus (the perineum) more supple and elastic. Combined with pelvic floor exercises, it also trains you as a mum to relax your pelvic floor, so that the baby can come out more easily.
By gently stretching the perineum and gradually increasing the pressure you apply during the massage, you increase the stretching ability of your perineum. Before birth, and without perineal massage, the birth canal is 2cm wide. Perineal massage before birth can progressively stretch this diameter to 10cm. This greatly reduces the chances of perineal tear and eliminates the need of an episiotomy. It ensures that the baby’s head comes out much more easily.
The use of perineal massage oil is important, as it reduces muscle tension, while softening the skin, which ultimately makes the massage more effective. Sweet almond oil, sunflower oil, and grape seed oil are some of the best options.
What Science Says About Perineal Massage
A range of clinical trials have been performed to scientifically determine the efficacy of perineal massage in preventing vaginal tearing. As early as 2006, these trials revealed that if you want to avoid an episiotomy, perineal massage is the way to go.
Subsequent studies have confirmed that perineal massage does reduce episiotomies. Further, they have found that the use of a vaginal dilatator before birth increases the chances of an intact perineum.
Conclusion
By all accounts, perineal massage does seem to work. And if professional midwives have been using it to safely deliver babies, why go against them? As far as the problem of differentiating between good and bad advice goes, this seems like good advice. And while perineal massage may not guarantee that you won’t get even a little perineal tearing, there’s so much potential gain and nothing to lose.
