Sooooo.... Anyone for perineal massage? :o

fro9etb8j5qsl2

I reluctantly did a little bit of it towards the end of my last pregnancy as I wanted to avoid an episiotomy at all costs. It's not the nicest or most comfortable of things to do but I figured anything that might lessen the chances of tearing etc would be worth it. As it turned out, I did have some tearing that required stitches but it wasn't that bad and the midwife claimed it was caused by my baby having big long talon nails when he was born :eek: So, I'm going to give it a go again this time and am hoping that by doing it religiously, I will avoid any tearing at all. Did it work for anyone else or is it just a load of claptrap? I used Mothercare own brand perineal gel last time (which was basically just an overpriced small vial of almond oil) but I've been reading a lot about evening primrose oil/capsules so might try that instead.

Nead21

Yep I did it last time for my first baby. I just used KY jelly as recommended by a midwife. I definitely think it helped as I only had a very small tear and I wasn't very bruised or sore afterwards.

pwurple

lol, love the title.

I didn't do this, had a chat with the midwife and consultant about it during my second pregnancy, as I had a tear on first birth, and was keen to avoid another. They told me that women/babies/births are all different, and it's really hard to tell scientifically whether the massage makes a difference or not.

I didn't bother in the end, had a lot going on, moving house, toddler etc. Eventually, In labour, I said again that I was worried about it. midwife there told me I would be in a higher risk of tearing because I had before, but they would do their best with a very slow bit at the end, to avoid it. I remember them telling me that I hadn't torn when the head was out, to my relief. But, a few minutes later, tear from shoulders.

The doctor later told me that I was one of those women with the anatomy that is more likely to tear as well... no idea if that was to make me feel better or if that is actually a thing, but there ya go.


tldr; Can't hurt, go for it if you've the time?

seventeen sheep

I didn't do it. I read up on the benefits, but I couldn't really see any scientific proof that it makes any difference.

I had an episiotomy that healed so well that my GP could barely see the scar at the six-week check.

I don't think I'd bother doing it in future pregnancies either, but each to their own.

Sligo1

Did it on number one and only had the tiniest tear that apparently didnt need any stitches... But stupid doc put a few in anyway. Did it in second got a little graze with no stitches. I put it all down to the perineal massage!

I didn't do the deed myself... Gave my lovely hubby the honours (lucky him aye)! Just used a bit of lube and gave it a good auld stretch . No tears for me

heldel00

Ah Jesus girls what are ya talking about? I only came in here to be nosey and now I'm curious but I'm afraid to google it!!!

(And just in case you think I'm being a weirdo we are newlyweds and are only just playing the whole getting pregnant malarkey by ear. So that's why I'm snooping in pregnancy forum)

seventeen sheep

heldel00 wrote: »

Ah Jesus girls what are ya talking about? I only came in here to be nosey and now I'm curious but I'm afraid to google it!!!

(And just in case you think I'm being a weirdo we are newlyweds and are only just playing the whole getting pregnant malarkey by ear. So that's why I'm snooping in pregnancy forum)

It's nothing weird.

The perineal area ie the area between vagina and anus stretches a lot when giving birth. Often it has to tear or else be cut (episiotomy.)

Many pregnant women prefer to tear naturally, or ideally, not tear or need to be cut. Some believe massaging the area helps.

heldel00

Ok. Thank you.
(Still not googling it though!!!)

seventeen sheep

heldel00 wrote: »

Ok. Thank you.
(Still not googling it though!!!)

Fair enough; personally I believe knowledge is power, especially when it comes to pregnancy.

Like it or not, it's likely that the area will either tear or need to be cut. Cutting was my own preference; if I had decided I'd rather tear, chances are I'd be looking into the massage from early on in the pregnancy.

fro9etb8j5qsl2

heldel00 wrote: »

Ok. Thank you.
(Still not googling it though!!!)

If you google it you'll get a load of helpful instructional how-to videos! :pac:

Sligo you're lucky, my OH refuses to have anything to do with it! He's great during the pregnancy and the labour but I think the thought of stretching the opening in preparation for a whole baby to come out is just too much for him I find the whole business an uncomfortable nuisance (picture an elephant standing on one leg trying to reach it's tail, that's me!). There's nothing to say for definite whether it does really help or not but I'd rather take my chances and do as much as I can to minimise the damage. I put NO EPISIOTOMY on my birth plan the last time because I'd heard awful stories of doctors performing them for no reason but the midwife told me that Limerick is one of the few maternities who don't perform them unless medically necessary anyway.

There's a balloon type yoke you can get called an Epi-No, it takes all the hassle out of doing the massage but they're nearly €100 :eek:

heldel00

Brylee Lively Weevil wrote: »

There's a balloon type yoke you can get called an Epi-No, it takes all the hassle out of doing the massage but they're nearly €100 :eek:

You could try donedeal for a second hand one! :D:D

Sligo1

Brylee Lively Weevil wrote: »

If you google it you'll get a load of helpful instructional how-to videos! :pac:

Sligo you're lucky, my OH refuses to have anything to do with it! He's great during the pregnancy and the labour but I think the thought of stretching the opening in preparation for a whole baby to come out is just too much for him I find the whole business an uncomfortable nuisance (picture an elephant standing on one leg trying to reach it's tail, that's me!). There's nothing to say for definite whether it does really help or not but I'd rather take my chances and do as much as I can to minimise the damage. I put NO EPISIOTOMY on my birth plan the last time because I'd heard awful stories of doctors performing them for no reason but the midwife told me that Limerick is one of the few maternities who don't perform them unless medically necessary anyway.

There's a balloon type yoke you can get called an Epi-No, it takes all the hassle out of doing the massage but they're nearly €100 :eek:

Lol... Tbh if my husband didnt do it I prob wouldn't have. I think I remember trying once myself and it was just impossible. Totally agree with the uncomfortable nuisance bit! I hated doing it. But I think I hated the thought of tearing more. I know this might sound silly but I was actually more worried about the thought of tearing and the stitches than I was about the labour. Second labour I had no pain relief... And I was still worried about the pain of stitches/tearing more than I was about the pain of pushing a baby out or the contractions at 10cm dilated!

I think that why we did it religiously every night for a month before I was due.

theLuggage

Tried this but found it too awkward so gave up. Had two episiotomies on both births. Just to add a positive side. Didn't hurt at all, stitches were no bother, healed fine and were not sore afterwards like you might think. The whole area is healing, the stitches are one part of it, didn't even notice them to be honest!

fro9etb8j5qsl2

theLuggage wrote: »

Tried this but found it too awkward so gave up. Had two episiotomies on both births. Just to add a positive side. Didn't hurt at all, stitches were no bother, healed fine and were not sore afterwards like you might think. The whole area is healing, the stitches are one part of it, didn't even notice them to be honest!

Did you request the episiotomies or did the midwife/doctor suggest it? And were the performed as a precautionary measure or was it necessary to have them done at the time? I can see how a surgical incision might heal better than random tearing but I'm just being super optimistic and hoping for no tearing at all

theLuggage

I never requested them. Both were suggested. First time I was over an hour pushing and exhausted, I would have agreed to anything to finish! That sounds bad but they just asked and I agreed, no probs. Second time I couldn't push fully it was too painful so it was asked again and I was happy for them to do it. I went into both births with an open mind and the feeling that midwives/doc know best - it's their job. I was happy to go along with their suggestions. I know that way of thinking isn't everyones but they are the experts and I never felt like I was in anything other than the best of hands.

Penny Dreadful

I googled it when I was pregnant and decided pretty damn quick that it wasn't for me.
In the end I needed no stitches anyway. My labour was quick (9 hours from first contraction to birth) and the baby did little damage to my nether regions and no stitches were required.

Mink

I did this every day for the last 2 weeks of pregnancy. Used the almond oil which ended up being great for cradle cap.

My sis had recommended it to me as she'd had no tears. I in turn had no tears. Both first time mothers... but it could be completely coincidental.

I definitely felt a bit ridiculous doing it. Felt like a teenage boy with my bottle of lube & tissues on my bedside locker.

fro9etb8j5qsl2

Just thought I'd share this interesting article I came across this morning:

http://www.scienceandsensibility.org/what-is-the-evidence-for-perineal-massage-during-pregnancy-to-prevent-tearing/

Interestingly, it seems that you're better off doing the massage only once a week as opposed to more often:

Surprisingly, Beckmann and Garrett found that the more frequently women used perineal massage, the less likely they were to see any benefits. Women who massaged an average of 1.5 times per week had a 17% reduced risk of perineal trauma and a 17% reduced risk of episiotomy. Women who massaged between 1.5-3.4 times per week had an 8% reduced risk of perineal trauma.

I've been doing it once or twice a week just in case it might help but I'm not overly worried in any case because I wasn't too bothered by the stitches the last time. I think the thought and fear of tearing is worse than the reality in a lot of cases.

comongethappy

I tried to do it myself when I was pregnant -I was just so big I couldn't do it properly, and hubby wouldn't help.

In the end midwife suggested episiotomy as percaution and I only needed small cut - five stitches in total. Wasn't very sore afterwards, didn't take any pain relief when I got home from hospital.

Only reason I said yes is because a mom in my friends bf group refused and massively tore - she needed several reconstructive surgeries. But tbh I think it is quite rare to go that severe and her doc had warned several times that her body couldn't handle it. My friend had refused when she had hers and had no problems, just little tear that needed 3 stitches.

SmokeyEyes

I was bold and never did it although other half would have happily helped out!

Had our first last June and as they were talking about getting forceps if I didn't get himself out they didn't get me to do a slow push out so it was his head in one push and his body in the next. I had a second degree tear but have to say I genuinely didn't really notice the tear postpartum, there was so much else going on it actually was the easiest part of recovery!

10021

Never done it. First baby c section. Second a VBAC only had two small grazes so no stitches. Definitely not going to be concerning myself with it with our third. That said had I done it with my second I would do it again.

Kash

I did it with my first, or at least, my hubby did, but ended up with an episiotomy (necessary, due to size of the baby and shoulder dystocia)

Unfortunately, the doctor who stitched me up did a pisspoor job and I needed to go back in again a few days later to get it re-sutured. So I'm nervous as hell about tearing or cuts, so I'll definitely be doing the massage again.

fro9etb8j5qsl2

Kash wrote: »

Unfortunately, the doctor who stitched me up did a pisspoor job and I needed to go back in again a few days later to get it re-sutured

Yikes you poor thing :eek: A friend of mine ended up with an infection in hers and had a lot of trouble healing.

Is it just me or are the midwives reluctant to tell you exactly how much damage you've done? They changed the subject when I asked how many stitches I needed and they tried to distract me while the doctor was stitching so that I hardly noticed what was going on. I never did find out in the end. I'm doing the massage 2 or 3 times a week so hopefully that will help somewhat

SmokeyEyes

Brylee Lively Weevil wrote: »

Is it just me or are the midwives reluctant to tell you exactly how much damage you've done? They changed the subject when I asked how many stitches I needed and they tried to distract me while the doctor was stitching so that I hardly noticed what was going on. I never did find out in the end. I'm doing the massage 2 or 3 times a week so hopefully that will help somewhat

Yes!!! I actually asked the guy stitching me up and he just said the average amount, didn't want to tell me so still have no idea! It was only when I saw record I saw I even had second degree tear

tfak85

A second degree tear is a normal part of childbirth, your midwife will do their best to control the birth of the head and shoulders, to minimise trauma but as with so many things, if it's going to happen it's going to happen.

Perineal massage can improve outcomes but it's impossible to accurately measure this - babies are different sizes, come out facing different directions, women are different sizes and some have stretchier skin than others. Perineal trauma can be affected by how strong the pelvic floor muscles are, the position the woman gives birth in etc.

A midwife or an obstetrician will not perform an epis unless there is a medical requirement - babys heart rate is dropping after pushes or to facilitate an instrumental birth. Occasionally they will assess if the perineum is short or not stretching well and may perform a prophylactic epis, though this is not common because it's easier for your body to heal a natural tear.

In terms of healing, this is greatly influenced by diet and lifestyle - the healthier you are the better you're likely to heal, if you look after your stitches like you would any other wound it should heal well.

Personally I will be getting an Epi-No towards the end of my pregnancy to help with preparation for birth, it also helps with pelvic floor exercises postnatally.

seventeen sheep

SmokeyEyes wrote: »

Yes!!! I actually asked the guy stitching me up and he just said the average amount, didn't want to tell me so still have no idea! It was only when I saw record I saw I even had second degree tear

Same here, I just wanted to know out of curiosity, but the midwife wouldn't tell me! It healed up very well anyways, thankfully.

By the way, something to keep in mind whether you get cut or tear naturally ... Don't be afraid to be assertive about who does the stitching! I've heard a few horror stories about women having problems with healing, often if the stitches were done by an inexperienced trainee midwife/doctor. I know everyone has to learn somewhere, but I just wouldn't be happy with them using my vagina for practice.

autumnbelle

tfak85 wrote: »

A second degree tear is a normal part of childbirth, your midwife will do their best to control the birth of the head and shoulders, to minimise trauma but as with so many things, if it's going to happen it's going to happen.

Perineal massage can improve outcomes but it's impossible to accurately measure this - babies are different sizes, come out facing different directions, women are different sizes and some have stretchier skin than others. Perineal trauma can be affected by how strong the pelvic floor muscles are, the position the woman gives birth in etc.

A midwife or an obstetrician will not perform an epis unless there is a medical requirement - babys heart rate is dropping after pushes or to facilitate an instrumental birth. Occasionally they will assess if the perineum is short or not stretching well and may perform a prophylactic epis, though this is not common because it's easier for your body to heal a natural tear.

In terms of healing, this is greatly influenced by diet and lifestyle - the healthier you are the better you're likely to heal, if you look after your stitches like you would any other wound it should heal well.

Personally I will be getting an Epi-No towards the end of my pregnancy to help with preparation for birth, it also helps with pelvic floor exercises postnatally.

Was just going to post asking about the epi-no, has anyone else used it? I was looking at them online but would love to hear peoples opinions on them

fro9etb8j5qsl2

I don't think the epi-no is very widely used in Ireland. I found this thread where some women have had some success with it:
http://www.mumsnet.com/Talk/childbirth/a984097-Epi-No-Luibricant-Birth-TMI-warning

TBH though, for the price of it, it would nearly want to push the baby out for you It would probably be useful for ftms who are frightened of birth and want to get used to what crowning will feel like but apart from that, given that you can do the massage without it, it is really just a very expensive pelvic floor toner. Great idea but with a new baby on the way, I can think of a lot of better things to spend €120 on.

pwurple

tfak85 wrote: »

In terms of healing, this is greatly influenced by diet and lifestyle - the healthier you are the better you're likely to heal, if you look after your stitches like you would any other wound it should heal well. .

Also helps if the person stitching you hasn't stitched a load of hair, and other random bits into the wound.... needing them to be pulled out and redone at a later date. grrr.


And NOT telling women what is going on with their own bodies when they specifically ASK is harking back to the days of symphysiotomy. If I want to know what stitches, how many and where they are going, f-ing tell me! I'm not the infant, I'm a fully grown woman and it's my body.

I wasn't told on my first, but by god I got a diagram drawn for me on my second before they touched me.

seventeen sheep

pwurple wrote: »

And NOT telling women what is going on with their own bodies when they specifically ASK is harking back to the days of symphysiotomy. If I want to know what stitches, how many and where they are going, f-ing tell me! I'm not the infant, I'm a fully grown woman and it's my body.

I wasn't told on my first, but by god I got a diagram drawn for me on my second before they touched me.

Fully agree with this ... when she didn't tell me, it made me wonder if there was something gone wrong with it. I don't know why I didn't push for more information, I guess I was just distracted at the time! I can't understand the logic in not telling the woman, if she asks.

I also didn't appreciate that I wasn't really asked as such - I was told, "I'm just going to make a little cut now" and I had to clarify whether she meant an episiotomy. I didn't mind getting one and was prepared for the possibility, but she should have asked me - not informed me. I can see why people like to have their birth plans/preferences there in writing, at least then there's no excuse for misunderstandings or issues with consent for certain procedures.

tfak85

pwurple wrote: »

And NOT telling women what is going on with their own bodies when they specifically ASK is harking back to the days of symphysiotomy. If I want to know what stitches, how many and where they are going, f-ing tell me! I'm not the infant, I'm a fully grown woman and it's my body.

I wasn't told on my first, but by god I got a diagram drawn for me on my second before they touched me.

Totally agree that all your questions should be answered and informed consent sought. While it may be scary you have the right to refuse consent, if you don't want someone to touch you, you can tell them no or wait etc. The majority of tears will be sutured with a continuous suture, so it's not possible to "count" them. The only time multiple sutures would be used is if you have something called button holing or grazes that are bleeding.

GavinusMaximus

Nead21 wrote: »

Yep I did it last time for my first baby. I just used KY jelly as recommended by a midwife. I definitely think it helped as I only had a very small tear and I wasn't very bruised or sore afterwards.

I had a similar situation when I had my second baby. Wish I knew about the KY jelly for the first as the bruising/tearing was more serious I believe as a direct result

Kash

tfak85 wrote: »

Totally agree that all your questions should be answered and informed consent sought. While it may be scary you have the right to refuse consent, if you don't want someone to touch you, you can tell them no or wait etc. The majority of tears will be sutured with a continuous suture, so it's not possible to "count" them. The only time multiple sutures would be used is if you have something called button holing or grazes that are bleeding.

I was going to mention the continuous suture as well, that was what I was told when I queried it, that there wasn't a number of stitches as it was actually just one. But it was a junior doc that did the stitching and it went horribly wrong (you never want to hear the term 'gaping wound' applied to your nether regions!!)

I was fobbed off at first with some daft explanation that the reason the stitches came out was because of my fair skin. Now, I'm of typical irish colouring, pale and freckled, so not exactly outside the norm in an Irish hospital. I called shenanigans on that excuse when I spoke to the senior consultant and though she did not openly contradict the original doctor, she explained that the stitches were simply not deep enough to hold. So I would second making sure that your birth plan specifies that any suturing is done by someone experienced!!

pwurple

tfak85 wrote: »

Totally agree that all your questions should be answered and informed consent sought. While it may be scary you have the right to refuse consent, if you don't want someone to touch you, you can tell them no or wait etc. The majority of tears will be sutured with a continuous suture, so it's not possible to "count" them. The only time multiple sutures would be used is if you have something called button holing or grazes that are bleeding.

Or if you have layers of stitches? 3rd degree etc.

fro9etb8j5qsl2

Does anyone know what used to happen in the past, before there was dissolving stitches? Did they have to go back after a week to have them removed or what?

tfak85

http://thejoyofthis.com/2013/03/15/birth-sensations-and-protecting-the-perineum-through-it-all/

This is quite a nice article about perineal care, the link about food to improve the skin integrity at the end is very good too.

qt3.14

Should be in the habit of massaging it anyway. It's a erogenous zone with lots of lovely nerve endings for both partners.

seventeen sheep

qt3.14 wrote: »

Should be in the habit of massaging it anyway. It's a erogenous zone with lots of lovely nerve endings for both partners.

nope.

NOPE.