Unable to do perineal massage

[puddleduck16]

So I'm now at 38 weeks and would really love to do perineal massage to help limit tearing (this is my first by the way). But on all the leaflets that I have it says not to do this with thrush, which I have suffered on and off for the past few months.

So my question is, if perineal massage is out of the question does anyone know if there's anything else I can do to help myself?
Thanks in advance

Water birth is meant to minimise the risk of tearing, have also heard that certain yoga postures can stretch the perineum but I have no idea what they are - possibly worth a google?

Oooi

I'll give that a google!!! I could give that a go for definite. Would love a water birth but as there's only 1 pool at my hospital I'm not getting my hopes up too much!!!!

Honestly, tearing is unpredictable and I don't think there's any evidence that perineal massage prevents it.

I had a water birth and a third degree tear. No other risk factors, just unlucky. And if it's any reassurance, I wasn't aware it had happened.

have you seen the epi no - i am trying it! anything to try and help avoid tearing

I've been reading a bit more this pregnancy, some of the books I have read have been about midwives delivering years ago before woman gave birth in hospital or books about MW working in quite remote areas, what some of these MW's did was amazing often in less than ideal situations. I've also read the Ina May Gaskin book (guide to childbirth).

In these books once the baby is almost out they seem to let the head pass really really slowly so that the perineum had time to stretch over the head...in some cases the mw would use her hands to help ease the perineum over the baby's head (I'm not sure how mw's would feel about doing that now). Letting the head pass really slowly may seem blinding obvious to some but it's never been something I've been encouraged to do in previous births so I've torn. I've almost felt like its been a bit like the start of the grand pix when the baby's head has appeared, go go go! push push push and he or she has been out in a flash!

Woah, I kind of assumed midwives would be doing that kind of thing. Damn.

My midwife made me stop pushing and "pant" through the head coming out instead so it happened slowly, and this is what was explained would happen at my antenatal classes too, never heard of pushing still to get the head out quickly...

Recent evidence suggests giving birth in water does not prevent tearing. Things that do are: birthing in a kneeling position (might be easier to do this in water), trying not to push hard or fast, listening to the MW's instructions on crowning to not push and to pant.

Try to be mobile and avoid epidural so that instrumental birth is less likely. MW should never tell women to try and push fast while crowning as this is likely to lead to tearing and the only time I could think this would happen is if the baby is in distress and even then they would be more likely to ask to do an episiotomy.

A huge part of it is luck but perineal massage has been shown to help a little. An alternative is to use an epi-no device (not sure if this can be used with thrush).