Supporting the perineum stretching during labour

[meow]

I've seen and heard of various support midwives have given to support the perineum stretching while baby is on the way out. Things such as hot warm cloths onto it or doing perineal massage. i like the idea of it and think I would like it to be tried if suitable during my labour.

What I'm wondering though is if it would be over the top to request this sort of thing on your birth plan? Is it more of an 'in the moment' if it's appropriate thing, or do you think it would sound okay to request possible perineal stretching support on my birth plan?

[leebee81]

Ren, I didn't need to ask, my midwife just did it. I was in a standing position, leaning on the raised bed, and the midwife was behind me on a stool, I think. She was using her fingers to massage the perineum during each push. I didn't tear at all though I did get three minor labial grazes which I hadn't considered as a possibility. Don't know how they would prevent those. Most of the burning pain was actually in front, not in the perineum.

[meow]

My birth plan currently says something similar... I might add another sentence suggesting actively supporting the perineum during stretching.
I could end up in the water too which I know is supposed to help- but for some reason I just don't visualise myself birthing in the water so I'd like to be prepared for a dry birth.
I think I might like to try that leebee- but I'd hate that no one tried and I tore... think I need to write it down so I know it's mentioned as a possibility.

[meow]

Hmm- I've been reading up on this and it seems that maybe it's just asking for too much interference. Supporting the head/perineum seems to be rather an unfounded idea that may actually be effecting the natural movement ans massaging at this time may just bruise and hurt the perineum.

[blue daisy]

ren

if you are calm and relaxed as your baby births, responding to your body and not necessarily what others are tellin you, this is the greatest way to minimise damage to the perineum

there have been numerous studies of hands on or off (the perineum and the babes head) and they mostly indicate that hands on does not reduce trauma

I would be inclined to suggest perineal massage, as this stimualtes blood flow to the perineal muscles and improves tone, whilst allowing you to become familiar with your vagina and the sensations that massage brings

also practice relaxing the pelvic floor to accomodate the smooth birth of your baby

water is the best medium to reduce tearing as it provides natural support

massage as the head is birthing can cause increase blood flow to the perineum which can cause venous congestion and acutally increase the risk of damage (the same principle applies to birthing stools. Also massaging the perineum also includes touching the baby's head as it births. This touch can have a negative impact apon a baby's first breath due to overstimulation, and also someone else is touching your baby before you

positions such as an all 4's or standing are positions that use gravity but provide adequate control for the birthing mother

semi reclining and squatting can increase tearing risk

hope this helps

x

[BellyBelly]

Directed pushing also increases tearing risk too... so go with your body, but listen to the coaching part when they tell you to slow down/stop on crowning to help with stretching. Blue daisy has given you all the good advice already but just wanted to add that one. Unfortunately it depends which midwife you will get at the birth centre as to who will let you actually birth in water. Last night we didn't get that She said the water is only for pain relief. Bring your own plug and tell her not to touch your property

[meow]

Thanks for the tips. I know perineal massage can be good before labour- was curious about it's use during birthing though and from what I can tell it's as you said blue daisy- potentially irritating and bruising.
Hmm... not so great news on the water birth front Kelly...