I think our perineums are wonderfully designed to stretch. Given time, patience and support, they generally do - even for large babies.

The object of perineal massage is not to *make* our tissues stretch, but just to find out how stretchy they already are, and get familiar with the sensations. So you become more confident that it can, rather than trying to force it to more. If that makes sense.

The Pink Kit teaches you how to massage internally and how to palpate your own cervix, so you can feel in tune with your body and confident in its capabilities. They say, "you're observing for changes" when you palpate your cervix. With the massage, it's to help you learn how relaxing with a slow exhale can totally soften and release the tissues - you feel the tenstion going under your own finger tips and a light-bulb goes on - "aha! I see how remembering to relax with an exhale when I feel these sharp sensation as the head is crowing, could come in handy for birth!"

I did find perineal massage helpful with my first baby because it did familiarize me with my body and the sensations. I went into birth sure that those tough, tensile tissues could indeed stretch, and they did. I found that as a first time mother I wasn't all that crash hot about intentional relaxation, expecially deep in my pelvis, and actually practicing it before birth did help during birth.

I think the likelihood of tearing or having an episiotomy has quite a bit more to do with the type of care a woman is receiving and what the atmosphere in the room is like at the time, and how her labour was managed overall, than her body's actual stretchiness.

Olive oil (or similar) on the perineum, warm compresses, birth in water, and choosing a careprovider who does not do episiotomies and who has a high percentage of intact perineums with first time mothers, are other factors to consider.

Leah, I agree with you that being more upright can help, too - the pressure is distributed better. And remembering to put the brakes on and *stop* pushing once you're fully crowing, and just gently breath the baby out can help give your peri time to stretch, too. There's no rush! Back-pedal, take your time .... gently does it.