Perineal Massage: when to start?

[TrippleBerryFairy]

Hello to all of you, I have just joined the mumsnet.
I am 25 weeks pregnant (my first pregnancy) and a bit worried about giving birth already... My worst scare is tearing - maybe naively but I am hoping to be one of the lucky ones not to tear..
I've come accross the thing called perineal massage (with almond oil) and would appreciate a bit of advice from you- when is it a good time to start it (still while pregnant or when in labour?).

Also, it seems like a good midwife can go a world of good with her advice when to push and when not to! I have only met mine once and didn't like her at all, she seemed not to care much (she just ticked the boxes in my antenatal care plan, was burping while I had my appointment and barely managed a smile... am I being too harsh with my opinion about her?...) So I'm trying to educate myself as much as I can in case she will be there and be unhelpful.. How many of you happened to have a midwife that wasn't of much help and how you feel that affected you tearing or not?

Appreciate every response.

[slushy06]

My midwife refused to check me after I told her twice I was pushing and only checked me as I leaked a large amount of blood I did no pre natal massage, my baby was posteriour but I didn't tear. At first I was pushing gently because I to was scared of tearing when my mw told me the longer the baby is in the birth canal the more pressure it puts on your perineum. At which point I pushed so hard I could barely breath he was out in 30 mins of pushing. My mw said in my circumstance pushing him out so quickly is what stopped me tearing. You are very unlikely to know what mw you will have when you go into labor as the do shifts and change every three months between anti natal post natal and delivery. So I wouldn't worry to much about your mw. the massages are supposed to be started in the third trimester I think. Hope this helps.

[TheMysticMasseuse]

Hi Mozarela, welcome to MN.

I think you are meant to start the massage about 32-34 weeks. there are lots of websites which explain how to do it. i used wheatgerm oil because of the high vit E content which is meant to be particularly good for tissues.

re tearing, i was terrified of tearing both times. i tore both times, 2nd degree tear both times. i had issues with my scar the first time (it needed to be redone after a few months, which sounds horrible but with hindsight it wasn't so horrible), and going into the second labour was absolutely terrified. i was stitched really well the second time though and haven't had any problems whatsoever.

i think whether you will tear or not is down to luck, genetics and circumstances. i think some things can help (the massage, giving birth in water etc).

ultimately though what really helped me mentally was to accept that i would probably tear (statistically, lots of women do) and that it was no big deal. i would get stitches, and i would heal, and it would be fine. because statistically, the vast majority of women have no problems. and even those who do have problems (like i did first time) get fixed up and everything is fine.

i hope this helps!

[TrippleBerryFairy]

Thank you, Slushy and Masseuse.

[RunJHC]

I started the perineal massage at about 35 weeks - did about 5 mins every day with olive oil. Then gave birth at home at 37+5 so didn't do it that much in the end! Didn't tear, but as Masseuse says, that could be down to lots of other factors as well as massage - I pushed for 1.5 hours in birthing pool and gave birth 5 mins after getting out of pool, and DS was only 6lb 6oz.

I had an excellent midwife as well who was very clear about how to push which helped a great deal.

I figured the massage was worth a shot, and then if I did tear, I would have known I'd done everything I could to have a good outcome IYSWIM!

[Rosebud05]

I had a longish 2nd stage with dd (2 hrs), partly because she had the cord tightly around her neck. I massaged my perineum most days from 34 weeks and I do think it helped. It was noticeably less painful the more I did it and it does sort of prepare you for the crowning sensation. Although I didn't tear, I had no idea until afterwards as it's so intense at the end that you don't necessarily know what's going on. I know a number of people who have torn, but haven't realised until afterwards. Do what you can to minimise the possibility, but as PPs say, it's common and usually doesn't cause major problems.
Another design fault in the whole process!

[Wilkiepedia]

Only thing I would point out is that I started with Almond oil at 30 weeks which promptly triggered thrush that I couldn't get rid of until I gave birth! If your fanjo is particularly sensitive (i.e you can't use perfumed soap, bubble bath etc), KY jelly is a good alternative.

HTH

[Allegrogirl]

I was absolutely terrified of tearing. I had intended to massage but found it so uncomfortable to reach down there gave up pretty quickly. I had 3 tears and two had to be stitched. They healed very quickly though. No where near as bad as I imagined. I only know one person who massaged regularly and she had to be cut as she wasn't stretching at all.

Due to doing NCT classes I got it into my head that it was my fault I tore because I had an epidural. I asked MW why I tore and she said it was because baby had a big head (which she had). DH said that there seemed to be some urgency from the MW to get the baby out. I was induced which I think can be distressing for the baby.

As to the MW you saw, you are very unlikely to get her on the big day. Here they have different teams in the community and the hospital so you would never get 'your' MW. My community MW was horrible and I regret not asking for a different one. See if you can get someone else.

Good luck. I know it's hard to believe but it's unlikely to be as bad as you think and could be much better.

[DiamondHead]

I wouldn't bother. Is there any evidence that it actually works.
I did nothing three times and didn't tear three times. It's luck of the draw.

[Jools78]

I used Neal's Yard Mother balm to massage for DD1 and the mw was amazed I didn't tear. I went from 3cm to giving birth in 5 hours and had no second stage whatsoever - the crowning of the head came as a real surprise to us all. I didn't actually realise I'd given birth - I thought it was a catheter going in.

The mw asked what I'd used for perineal massage afterwards as she thought I would have torn so I can highly recommend the Mother Balm for it.

Good luck!

[LoveBeingAMummy]

Hello and welcome!

You've probably been told this before but you really won't even know you've tore (if you do). I had 2 second degree and have to say I really had no idea. Mine was due, i think, to myself as the baby was is distress and was told they were going to use forceps if the vontuse didn't work. In the end five pushes and she was out and the doc said he only guided her head (so no cone head {grin})

Another of my big fears was having a catheter being put in and had been for ages even before i was pg, but again I didn't feel a thing.

There's a lot going on down there!!!