I thought I would talk about a topic I think is so important for women. Many women don't know what or where their perineum is located and how important it is to their physical and maybe indirectly to their emotional well-being. We start our lives wearing a nappy and I for one do not want to spend my latter years wearing them because of stress incontinence, not to mention the embarrassment and poor body image!
Luckily, we now know that spending a few minutes a day during the latter weeks of pregnancy massaging the perineum can help it to stretch during labour, reducing the incidence of tears and trauma with long term consequences. Don't forget even if you do not need stitches it is still important after delivery to strengthen the muscles again by doing your pelvic floor exercises, preventing prolapse of the uterus and the dreaded leakage!
Perineal Massage:
The perineum involves the skin and muscles between the vagina and anus. As your baby’s head is crowning, the pressure of the head on the perineum stretches and expands the perineaum enabling the baby to be born easily. On occasion the perineum is unable to stretch sufficiently and tearing may occur.
Several research studies have shown that perineal massage during the latter weeks of pregnancy is helpful in preventing the incidence of tearing, lacerations and the need for an episiotomy.
Directions:
Perineal massage should be started at about 34 weeks gestation either by you or your partner. You will need some vegetable oil such as organic sunflower oil or a blend such as Mama2b perineal oil. These oils contain nutrients which can be absorbed by the tissues, whereas mineral oil just coats the surface. Use a mirror initially to see what you are doing if practicing yourself. Find a comfortable, private place to perform the massage and don’t forget to time yourself too!
Positioning:
Massaging yourself may be easier if you stand with one foot raised and resting on a chair, or the bath, using your thumb to massage yourself. If your partner is going to assist you, you can relax in a semi-reclining position, propped up wih pillows, legs apart and supported with a pillow under each knee. Your partner can use the index and middle finger to perform the massage.
Technique:
Take a few deep breaths to relax and then dip two fingers in the oil and slowly and gently insert them 1 to 1.5 inches into the entrance of the vagina (maximum up to second knuckle). The fingers pull down gently and then sweep from side to side from 3 o’clock to 9 o’clock and back again. You should feel a slight tingling or burning sensation, but not pain. Ease off if it is painful and build up gradually. The movement replicates the way the perineum stretches during birth. You can also massage the outside area between forefinger and thumb. Start with 2 minutes the first week and increase slowly until you can massage for up to 5 minutes.
Benefits:
The ability to participate and enjoy a more comfortabel birthing and postnatal recovery. It can be particularly helpful if you have previous scar tissue or a rigid perineum from exercise such as horse riding.
Reference:
Shipman. MK. et al. Antenatal perineal massage and subsequentperineal outcomes: a randomised controlled trial. British Journal of Obstetrics and Gynaecology. 104(7): 787-91, July, 1997.
Contact Amanda at amanda@mama2b.com or www.mama2b.com
Well thats it for this week. I will jump off my soap box now and do my pelvic floor exercises!
Take care until next time.
Amanda
No comments:
Post a Comment