Perineal Massage/Episiotomy/Stretchy Skin

I'd been feeling a tad guilty because I've heard that perineal massage can reduce your chances of having an episiotomy but I hadn't actually got around to giving it a go.

Anyhow, I asked my midwife and she said don't bother because it doesn't make any difference. (I realise that this is just one person's opinion and there will be lots of people for whom it seems to have worked). But she did say something interesting about it being more about your skin type/genetics and how stretchy your skin is naturally.

She basically said if you have olive skin your skin is likely to be quite stretchy whereas if you're pale (like me) your skin is less stretchy.

I did point out that I thought my skin was quite stretchy as I 'm 38 weeks and don't have a stretch mark (yet).

Anyhow, interested in hearing other people's experiences particularly if there was any correlation between stretchy skin/stretchmarks and having an episiotomy.

well i haven't had mine yet to tell you! but my cousin who has VERY olive skin and no stretch marks and did the massage, but ended up with an episiotomy anyway... don't know if it makes much difference about skin colour.. i'd say it's just about how big the baby is and how much you will stretch...? my mum had one with my brother but i just popped out! :) haha but he was bigger..

I did a little bit of massage, but not much as I just couldnt be bothered and felt awkward. I did get a second degree tear, and the obstetrician wanted to do an episiotomy but I said No, so he didnt do it. I didnt have any stetchmarks at all.

I've heard mixed views about the massage. It was recommended for us to do it when I went to my birthing class though. I haven't done it, personally. Also, I have olive skin and my stretch-marks are so bad my belly seems to be doing an excellent impersonation of a watermelon :(

Neuri
39 weeks

I started doing p. massage but felt a bit silly so I gave up.
I have fair skin. Only got stretch marks on my bb's, none on my belly. And I had a 2nd degree tear (Similar to Karina, my obst said did I want an episiotomy or just let things happen, which I said I would rather tear naturally. Which I did. I am tiny but! Afterwards he said my tear was much the same as an epi).

Thank you ladies for sharing your experiences.

Jelvie, can I please borrow your perineum in a couple of weeks?

Thanks

Fiona

I did perineal massage with my first and had not a stitch :) but I didn't have a stretchmark either so it could be my skin.

This time I have been slack and not done any perineal massage yet. But I also haven't got any stretchmarks yet either.

I think alot of tearing or not can be to do with your carer and your position when delivering as well. If they support the perineum, and you are more upright it can really help. Also if bub is not in too much of a hurry that can help to allow stretching rather than tearing.

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.

Thanks Julie Doula for that great explanation - makes total sense now.

PMSL, Fiona, at borrowing someone's perineum! LOL, at least that way if you do tear you can have your own in-tact one back afterwards!
I was really panicky about having a tear or epi when I was pg. It scared me more than anything. I only did peri massage once, tho, because I laziness won out over fear ;)
I had a 2nd degree tear and TBH it caused me no grief at all, besides being a little bit itchy when it was healing.
All the best for the last couple of weeks of your pg and for the birth.

Thanks Snacks. To be honest, I hadn't really given an episiotomy a lot of thought until the last few days being very much of the belief that if I need one I need one and by the time I've been in labour for goodness knows how many hours I honestly don't think I'll care. Nonetheless, it's VERY good to know that yours didn't cause you probs so thanks for posting that reassurance!