Very nice support for the perineum when you give birth in water.
I feel that perineal massage pre-natally can be helpful in terms of familiarity with your body and confidence in its tensile strength and elasticity. Just do it all gently - you're not *making* it stretch - it already can and does - you're simply finding out that it does stretch and satisfying yourself that it already is quite capable.
I also found that as I felt the sensations, I practiced totally relaxing with the exhale of my breath. That's great practice for labour, I found - using breath to relax when I felt intense or uncomfortable sensations - instead of tensing up.
When the head is crowning, you could ask a support person to remind you to stop pushing, exhale and basically - do nothing - just let your body do its thing and *b*r*e*a*t*h your baby out ....
Some women like warm compresses and olive oil or similar on the perineum during crowning also.
Also - our bodies are truly amazing - and they work. They do stretch, and sometimes, if they need to, they tear. The more gentle and unrushed and supported the birth is, the more likely it is that you won't tear or will only tear a little. I feel that a tear is still better than an episiotomy. It's been my expereince that tears, even when a few stitches are needed, heal well - and are not as painful as healing episiotomies.
I also use a herbal bath for the post-natal mother (herbs known for astringent & antiseptic properties, along with a good amount of sea salt), and I've read some research about how Manuka Honey (active) is quite amazing for healing the peri. (Sticky, sure - but that's OK if you're about to sink into your herbal bath in a while!)
We also use these peri-squeeze bottles - great when toileting during those first tender days.
Anything that can build your confidence in your body and enable you to relax and just 'let go' and trust when the time comes will help.
Pelvic floor exercises during pregnancy can help with this too - it helps you practice first tightening those muscles & tissues - and then intentionally letting them go. This exercise increases blood flow and oxygenation to the perineum.
I hope all goes really well for you Jess.
Last edited by Julie Doula; August 2nd, 2007 at 11:35 PM.
I found perineal massage difficult over the (giant) bump but i did it once or twice.
I used sweet almond oil, rubbed on the area, then slid a thumb in with the nail up and pushed down on my perineum from inside. After a few goes i used both thumbs (hard to breathe - take a lot of breaks ) and basically stretched out the area a little by pushing down and then sliding my thumbs apart. You do notice (or i did) how much better and easier it stretches if you maintain and slowly slowly increase pressure, rather than just jerking a lot of pressure on, so that's handy for keeping you focused on crowning slowly if possible.
I also want to tell you though, i was REALLY worried about tearing, it was a big thing in my head. I did tear a little (didn't need stitches) and honestly, i didn't feel it at the time and it gave me NO problems afterwards. I can find the spot with my fingers but i don't have a big scar or anything and i was DTD 8weeks PP with no pain or problems. I talked to so many women who were the same, the only ones who found it to be as awful as they expected tore really badly (bad 2nd or 3rd degree which is very rare with a normal deliver (those i know that had this level of tearing had instrumentally assisted births)). Without exception those who either had a little tear with no stitches or a little tear with a few stitches were actually laughing about how worried they were afterwards. You might tear your whohaa a little bit, but you won't even know about it until you're already holding your baby, and NOTHING seems interesting compared to that beautiful little person. So try not to worry too much.
Perinieum Massage
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) and basically stretched out the area a little by pushing down and then sliding my thumbs apart. You do notice (or i did) how much better and easier it stretches if you maintain and slowly slowly increase pressure, rather than just jerking a lot of pressure on, so that's handy for keeping you focused on crowning slowly if possible.
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