7800 Wolf Trail Cove, Germantown, TN 38138 • (901) 682-9222 • Open Weekdays 8:00 - 5:00
PERINEAL MESSAGE
Starting around the 34th week of your pregnancy, you could try daily prenatal massage of the perineum (the area around your vagina). Perineal massage may increase the stretching ability of the area, leading to less need for episiotomy and fewer natural tears. (Editor's note: There isn't any hard evidence that this technique will help you avoid an episiotomy or make any real change in the flexibility of the skin in this area. But it can't hurt if you want to try. )
With clean hands and trimmed nails, try this technique yourself, or have your partner do it for you. If you do it yourself, have a large mirror handy as well, to help familiarize yourself with your perineal area:
- Sit in a warm comfortable area, spreading your legs apart in a semisitting position. Put Vitamin E oil (from punctured Vitamin E capsules) or pure vegetable oil on your fingers and thumbs and around your perineum.
- Place your thumbs about 1 to 1 1/2 inches (to or just past your first knuckle) inside your vagina and spread your legs. Press down toward the rectum and toward the sides at the same time. Gently and firmly continue stretching until you feel a slight burn or tingling.
- Hold this stretch for about 2 minutes--until the tingling starts to subside.
- Now slowly and gently massage the lower part of the vaginal canal back and forth, hooking your thumbs onto the sides of the vaginal canal and gently pulling these tissues forward, as your baby's head will do during delivery. Keep this up for 3-4 minutes.
- Finally, massage the tissues between the thumb and forefinger back and forth for about a minute.
- Do be gentle, as a vigorous touch could cause bruising or swelling in these sensitive tissues. During the massage avoid pressure on the urethra (urinary opening) as this could induce irritation or infection.
Of course, perineal massage is not for everyone and it may not help in every case. The most important thing you can do is to choose a midwife or doctor who is experienced and comfortable delivering babies without cutting an episiotomy. In general, midwives tend to perform this surgery much less often than physicians. Regardless of the type of practitioner you choose, you should certainly discuss your wishes and expectations with that person before the birth.
Thomas G. Stovall, M.D.
Dr. Stovall is a Clinical Professor of Obstetrics and Gynecology at the University of Tennessee Health Science Center in Memphis, Tennessee and Partner of Women's Health Specialists, Inc.
Date Published: 2004-03-23
7800 Wolf Trail Cove, Germantown, TN 38138
Phone: (901) 682-9222; Fax: (901) 682-9505