P is for

P   E   R   I   N   E   U   M    of course!

My 4 year old is learning to read and write and it’s all done in phonics so we can only spell things out veeeeery slooowly in this house at the moment. Anyway yes perineum, do you know what it is and where yours is? Sounds like a stupid question right but at a recent girls supper party a friend of mine didn’t know where her perineum was, in fact she read my post about the girl with the amazing birth partner and thought that the sacrum was your perineum. Oh how we all laughed but secretly I was a little concerned. To be fair she’s not a midwife or a mother yet so she’s got lots of time to find out all about down there when the time comes.  Most people cringe when they hear the word perineum, it’s a bit odd sounding isn’t? And there are lots of other names for it ones I don’t tend to use when talking to women about theirs.  Basically your perineum is the piece is the muscle and tissue that lie between the bottom part of the vagina and the anus.  Prior to having babies you probably don’t ever think about it but when you’re pregnant suddenly your midwife is talking about it like its public property.

The reason I’m talking about perineums is because recently at work I’ve been conducting a little audit (in my head) of all the babies I’ve delivered and if any what sort of tear did the woman sustain.  Of those who had no tear or a very little graze which wouldn’t requiring stitches, I’ve asked them (where appropriate) if they did any perineal massage during pregnancy.  WHAT! Massage down there during pregnancy, the last area you want to touch or even can physically reach! Yes I know it sounds all a bit ouchy but seriously my findings have been really interesting. Perineal massage isn’t something new at all, women have been practising this for centuries but only recently have I noticed more information about it on NHS leaflets, online forums and websites not to mention the amount of women who ask me ‘is it really worth doing?’  Most women worry about getting stretch marks in pregnancy and the shelves are full of various products promising to be the ‘magic’ lotion or cream to stop stretch marks during pregnancy, some range from affordable to quite frankly ridiculous and I for one used my cream religiously twice a day from about 20 weeks pregnant until 3 weeks post natal.  So why such the screwed up face when I mention to women about massaging down there?

Of the women I asked following the birth of their baby, the ones who didn’t tear or only had a graze all said they did some sort or perineal massage during pregnancy.  And as a midwife I could tell as the baby’s head was crowning, that the perineum had been prepared in one way or another as it stretched so beautifully (sorry but us midwives so love talking about perineums).

The best time to start perineal massage is around 34 weeks pregnant, and I would recommend using an oil such as olive oil, sweet almond oil or sunflower oil.

  • Start once you’ve had a bath or shower as you’ll be more relaxed and the tissue will be softer and more comfortable to touch
  • Prop yourself up against some pillows, you can use a mirror if this helps
  • Place your thumbs about 3cm inside your vagina.
  • Press your thumbs downward and sideways gently until you feel a tingling.
  • Hold this stretch for about two minutes.
  • Gently massage the lower part of the entrance to your vagina for about three minutes
  • Continue this once or twice a day, after a week you will notice an increase in flexibility and stretchiness

Some people suggest asking your partner to help with perineal massage, my husband looked at me like I was mental and to be honest I was quite happy with doing it myself.  I know some of you reading this may be thinking no way am I going to do this, but seriously it might mean the difference between a second degree tear and needing stitches. So pregnant ladies next you reach for the olive oil when dressing your salad, remember it’s other qualities too.

14 thoughts on “P is for

  1. Actually, I know something that’s quite good at preventing torn perineums, it’s definitely as good as massage – C-sections! Ok, they are still invasive but I think they must be less painful than a bad rip. Urgh.

  2. Hahaha! What a great blog! But who ON EARTH was that silly friend of yours who didn’t know where,or what, the perineum was!! 😉
    Thanks for the advice/instruction manual…I will be sure to give it a go one day!! That day might just be sooner rather than later……
    Xxx

  3. Very interesting post. I must admit I had never heard of the word until I got pregnant. I had 3 kids, no tearing. And no massage either. I did have them all in water, which might be the reason? They say it helps.
    Also, they were all homebirths, and with my first they let me push really long, in the pool (hours, literally) I think that just stretched things really nicely and slowly so he came out finally without any damage for either (and me very happy I was not in hospital where it would have ended very differently)

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