perineal massage

one of our friends who gave birth last year had an episiotomy.. this is a surgical incision done to enlarge the vagina during childbirth if needed.. the incision is done on the skin between the vagina and the anus (ouch!)

i was thinking if this can be prevented and the answer is yes.. sort of.. there are things that can be done to help prevent it..

one of which is a massage called the perineal massage that can be done starting at 34 weeks to help stretch the perineum which will be the one being stretch by the baby's head during birth..

here is how it's done as written by brenda lane in one of her articles in suite101.com

How to do Perineal Massage

Perineal massage can be done by you or your sexual partner. The first few times, take a mirror and look at your perineum so you know what you are doing. Be sure your fingernails are short. If you or your partner has rough skin, it might be more comfortable to wear disposable rubber gloves. Wash your hands before beginning

STARTING POSITION:

Make yourself comfortable, in a semi-sitting position, squatting against a wall, sitting on the toilet, or standing with one foot up on the edge of the tub or a chair. Some women may find it comfortable to do perineal massage in the shower.

MASSAGE:

1. Lubricate your fingers well with oil or water-soluble jelly. Some people recommend wheat germ oil, available at health food stores, because of its high vitamin E content, but other vegetable oils, such as olive oil or water-based lubricants such as K-Y jelly can also be used. Do not use mineral oil or petroleum jelly. Wash your hands before dipping into the lubricant again.

2. Rub enough oil or jelly into the perineum to allow your fingers to move smoothly over the tissue and lower vaginal wall.

3. If you are doing the massage yourself, it is probably easiest to use your thumb. Your partner can use his index fingers. Put the fingers or thumb well inside the vagina (up to the second knuckle); move them upward along the sides of the vagina in a rhythmic U or sling-type movement. This movement will stretch the vaginal tissue (mucosa), the muscles surrounding the vagina, and the skin of the perineum. You can also massage by rubbing the skin of the perineum between the thumb and forefinger (thumb on the inside, finger on the outside or vice versa). In the beginning, you will feel tight, but with time and practice, the tissue will relax and stretch.

4. Concentrate on relaxing your muscles as you apply pressure. As you become comfortable massaging, increase the pressure just enough to make the perineum begin to sting from the stretching. (This same stinging sensation occurs as the baby’s head is being born at the end of the pushing stage.)

5. It is recommended to do this massage for 5-10 minutes daily from the 34th or 35th week of pregnancy until labor. Check with your caregiver if you have questions.

Perineal massage is only one way to help stretch the perineum. See the articles on avoiding episiotomies and writing a birth plan for more information.