Note: This information is intended for educational purposes only. You should seek further advice and instruction from your chosen healthcare professional.
It is during the second stage of labour that the baby’s held will begin to crown. At this point, the tissues of the perineum will stretch open in a fan shape. Factors such as the birth position and the baby’s position will have an impact on whether the perineal tissues tear or whether an episiotomy may be necessary.
During the last trimester there are several things that you can do to help reduce the chances of either perineal tearing or an episiotomy. Regular stretching exercises and pelvic floor exercises. Practise birthing positions. The position in which you give birth is important too! Upright (sitting, squatting, kneeling) all reduce the strain on the perineum.
Perform daily perineal massage in the last 6 – 8 weeks to nurture, condition and become familiar with the perineum.
Benefits of Perineal Massage
• Perineum becomes more supple and elastic and therefore reduces the chance of perineal tearing or an episiotomy.
• Prepares you for the feelings of pressure and stretching when your baby’s head starts to crown. Knowing what these sensations are like enables you to relax and as a consequence this can lead to a quicker birth. Tension will delay your baby’s descent.
• New emotional feelings may be bought to the surface. This will allow you to explore and discuss these feelings with your partner prior to the birth and can help you to develop a deeper understanding of each other. Examples of some emotions you may feel are fear, uncertainty, overwhelming love, excitement etc.
• Perineal massage during labour helps to ease the tissues around the baby’s head as it is crowning and obviously benefits both mother and child. This area is very sensitive during the birth so it is often more beneficial for the mother to undertake perineal massage during this time.
Tips for your partner
• It is critical to be a good listener. • Make the most of being together before your baby is born. • If you are not already doing so, begin to share the household chores. • Two-way communication is very important. Share your feelings/concerns with each other. • A little nurturing and pampering won’t go astray! • When baby is born and comes home – make sure you spend time to get to know your baby.
Partner relationship/communication during Perineal massage It is important to talk about any feelings that surface (if any). We have found that couples have experienced the following thoughts/concerns
- “I don’t want him to see this is a sexual activity.
- ”“I feel very intimidated at the thought of perineal massage.
- I don’t think I will do it.”
- “For some reason I feel ‘exposed’ and so I don’t want my husband to get involved in this.
Some positive thoughts:
- “I think this will help me to overcome the inhibitions I am currently feeling.”
- “I’m glad I am doing this now so that I can relate to the sensation of my baby’s head crowning during birth.”
- “I’m not sure if I can do this.”
- “I’m worried about hurting her or just not doing it right.”
Some positive thoughts:
- “I’m glad she feels confident enough in our relationship to let me do this.”
- “At least I feel I am helping in some way.”
- “I think it is building our trust in each other.”
Whilst the instructions below will help you with perineal massage, it will be far more beneficial for both you and your partner to seek advise (face to face) on perineal massage from an experienced instructor during pre natal classes or one to one ‘tuition’. You will find it far more personal and you will be able to ask questions (both general and specific to your situation) and draw on experiences from other people.
— Avoid the urinary opening during perineal massage.
Have a warm bath or apply warm compresses to the area to relax the whole body and tissues. – Wash hands and clip nails. – Use a mirror to become familiar with the massage. – Find a comfortable place and lean back with legs bent and open. Alternatively, stand with one leg upon a chair. Do what is most comfortable for you. – Place a small amount (about the size of a 5 cent piece) of Essenture Peri Balm
on your thumbs and around the perineum. – Place your thumbs about 3-4 cm inside the vagina, press downwards and
then gently separate thumbs and take out to the sides. Gently and firmly keep stretching until you feel a burning and stinging sensation. Take it slowly, remember to breath (stretching on the outbreath). Hold the pressure for a minute or so until it numbs the area.
– Release and again massage back and forth working the balm into the tissues. Pull gently outwards on the lower half of the vagina with your thumbs inside, just as the baby’s head will stretch it during birth.
Warning: — DO NOT DO PERINEAL MASSAGE IF YOU HAVE ACTIVE HERPES/THRUSH OR IF YOUR WATERS BREAK EARLY