Anyone tried the perineal massaging? Did it help avoid episiotomy?

[FJMi]

I've read about it. I wonder if it works?!

hi FJMi.
th perineal massage worked ok for me, it real helped to relax me, and stoped me from worrying too much about if i would tear or not.
unfortunatly i did still tear slightly, but i think the it would have been a lot worse if i hadn't done it.
so in my opinion it is worth it.

x

I'm still a bit confused about how you do it properly and not sure I can reach round my bump LOL x

Not sure myself.I did it diligently for both 1st two births,one ended up in a CS, the other was a VB but I tore a fair bit, mostly as I was more scared of the episiotomy than a tear.. Plus DS was nearly 4.5kg, Dr said if he had been smaller, I would have been fine.. I havent bothered at all this time, mostly as I found the massage awkward and generaly a pain in the hole to do. Plus a small tar isfine, Dr said in 25 years of his attending births, he has seen only 3 women who havent torn. So, pretty usual to tear. The stitches were fine for me. It's easy tho, but best reached from the front..There are loads of threads explaining exactly how to reach and what to stretch.

DS2 8lb 12 oz did it and no tear at all

DD again did it .. she was 8lb 3oz and was back to back .. only hade a small graze.

DS! didn't do it.. and have lots and lots of stitches.

Hi, perineal massage was very much on my to do list with my first but tbh I found it difficult to do alone and only managed it on a very sporadic basis.

However, what might help if you are worried about perineal damage is trying not to give birth whilst laying on your back. My DS (7lbs 12ozs) was born with one hand on his head and the other on his check. I had chosen to deliver on 'all fours' (kind of draped over the head of the bed) and my MW said that due to DS's strange presentation she would have expected at least a 2nd degree tear had I delivered on my back. Apparently I did have a very minor graze but I wouldn't have known and it never gave me any trouble.

I had chosen not to give birth on my back specifically to avoid tearing/episiotomy so was pretty pleased with my decision after I heard that!

His cheek not check

Must start reading posts back before posting...

Sorry, just had to comment on the extraordinary statement from Luxmum's doctor. 25 years attending births and only ever seen 3 women not tear???????? How many women has he actually attended? What on earth is he doing to them that he sees such incredibly high rates of perineal trauma? I would be looking for someone else to help me give birth if that's his idea of normal.
I am astonished.................

I had two episiotomies and three tears. TBH, I didn't notice any of it happening, except for the pudendal block jabs. Last delivery I lay on my side, sort of, and midwife massaged while I laboured. Still had a slight tear. As long as they take care about how they stitch you up afterwards you should be fine. I was given icepacks every time to improve comfort and speed healing.

So I don't get this specifying what position to give birth! Don't midwives just let u get in any position that you are comfortable with? What happens if you don't specify anything, do you have to give birth on your back by default?

Sorry I may sound stupid but it is my first one and I have no idea what happens!

I'd say yes definitely try perineal massage. I did with both of mine and didn't tear at all (though they were both less than 6.5 lb, which might have been a factor). Regarding birth positions, I think it depends on what you want, how tired/with it you are, the midwives etc. It's worth doing some research now about the benefits of different positions as during labour will not be the time to weigh up pros and cons!

FJMi - I've only done it once so far so hardly speak with experience! However, FWIW I moved around the room at will and was able to assume whatever position I liked when it came to delivery. I never really discussed it with my MW, although I had written something to the effect of 'I'd rather avoid delivering on my back to minimise tearing and would like to be encouraged to deliver either on all fours or in a more upright position' on my birth plan (as I was worried about forgetting!)

Not sure how it is at other hospitals or with other MWs. Might be worth asking your community/ante natal midwife for his/her thoughts?

FJMi Traditionally, you had to lie on your back with your feet up in stirrups. This makes it easier for everyone except the mother. Midwives may assume lying on your back is what you want unless you specify something different.

It's very important for you to do research of your own and discuss beforehand what will happen when you're giving birth. Otherwise assumptions will be made. Usually you will end up doing what is most convenient for the staff. Your birth partner can speak up for you about the details of the delivery and your preferences too, so he or she should be aware of the same issues.

Plus, you may need monitoring or other interventions that may make walking around impossible. You might end up confined to bed, and you need to discuss the possible wrinkles and how these might narrow your options too. I was confined to bed after being induced with gel. All kinds of situations can develop. Best to have talked about things in advance with all concerned.

didn't do it, didn't tear or need cutting

Sorry but friend has different experience to Lucasmama08. Basically being on your back slows down the babies passage out of the birth canal (think about gravity) and if it is a bit slower the area has chance to stretch so less likely to tear. My friend said to midwife she didn't want to tear so MW put her on her back for 2nd stage and she had a few grazes but no tearing at all- whereas if you are squatting or on all fours the baby can come out much faster and increase chance of tearing.

Hi, back to the comments, I thought it was a high rate?number too, yes, it could be that here in Luxembourg women?drs prefer an episiotomy to tearing, but that's what he said..unless I misunderstood him.. But the whole birthing procedure is very much more medicalised here - homebirths are unheard of, and the only pain relief is an epidural (bless them). Then again,he is an effing brilliant Dr, and I see him every 2 weeks during my pregnancy , he delivers my child and is the best surgical obstratrician (sp?) in the country. I'm having a water birth this time, maybe that will soften everything down below. TBH, I found the tearing nothing,a few stiches which did sting while peeing, but nothing major and I didnt give it any thought.

I didn't massage and I didn't tear. I've found through both my experience and that of friends that listening to your midwife, keeping calm, and pushing when told, relaxing and breathing when told can also reduce risk of tearing and episiotomy.

Massage isn't going to hurt anyone though, go for it. My next one I'll deffo give it a go, might help things along. Tearing and episiotomy talk makes me cringe. I must just have a thingy like a welly top. Popping out kids like shelling peas lmao.

i used massage from about 34 weeks.

well actually i could not reach so my husband did it! Tmi maybe but the last few weeks of being just the 2 of us were pretty much filled with amazing sex as the "massage" broke down a lot of barriers.

8lb 2 baby and no tear at all. will be doing it again and my husband will tell any dad to be that its totally essential!! lol.

I did it - but not religiously - for the last few weeks and had no tear, no episiotomy. Baby small so that might have had something to do with it. However, both my mum and my sister had equally small babies and both had terrible tears so maybe it worked. Will definitely do the same again.

Am i stupid to be scared of episiotomy.

Since my first was by programmed c-section cos she was breech never given birth vaginally before.

Midwife says episiotomy is likely so as to cut time of pushing stage and not put pressure on scar.

Anyone bn through similar situation of trying vaginal birth after c-section and been told episiotomy likely?

There was an article in the British Medical Journal some time ago (could be years) that stated that it did work, but something like 6 women had to do it regularly to prevent one of them having a tear (cant remember exact number, around 6 I think). ie 5 women will be diligently doing perineal massage and not gaining any benefit, but 1 woman will - and it could be you.....

ps.I didnt do it - one tiny tear first time and second time zilch. My sister has had 3 babies and not had a single tear, all delivered on her back. Not sure what that dr is talking about.

i did with my Ds born 4 weeks early via induction 8lb 11oz. no tear, delivered on back. will be strting it again in a few weeks! good luck. plus friends who have had episiotomy said they didnt feel it as they wwere focused on other things.

I did it from 35 weeks (well, DP did) and had baby at 40+6. had episiotomy and 2nd degree tear due to forceps delivery. the episiotomy healed really well, no problems with that, but the tear is still a mess 9 weeks later - have to see a Dr about it soon!

I did it from 35 weeks and know I did it right as it was v uncomfortable, verging on painful, and only did about 6 times but each time it felt 'looser'.

DS1 - no tears
DD - only very minor superficial tear from speed of exit (2 push pop)

Unfortunately I think it is probably more down to midwifery skill and your genetic make up (baby size vs exit size etc) BUT got to be worth a try.

I think the one thing that almost certainly guarantees an episiotomy is an epidural as I've heard it slows labour (=fatigue) and means that you have less control over pushing so often need intervention to get baby out which enevitably results in more trauma.

Both mine were gas and air so this could be a factor but I know that everyone experiences pain differently and for some the epidural was way more important than any damage there (which will heal!).

Good luck !! (oh and best way to do it is one foot on the toilet and thumb pointing backwards pulling down!)

Surely there is no way to know if it works?

But there's no harm trying as it might help and won't do any harm.