Nervous about starting perineal massage.

[etwahl]

I'm at the point where I'm supposed to be doing them every day, but I'm scared to start. Can anyone give any tips or pointers to make this easier/more comfortable? Keep in mind I'll be doing them myself.

Tammy,
Mom-to-be Mar 8, 2003!

[newbelly2002]

Aieee....now that's something I don't miss. I had my DH do it starting about 3 weeks before the due date. And he approached it with about as much excitement as his next dentist appt. I ended up doing it many nights myself.

We/I used avocado oil (but any internal, fruit oil will I think do)and a book on massage to show me the correct position and technique. I also needed a towel. It can get messy.

It was pretty painful at first, but stick with it. In the delivery, I had very minimal tearing and no episiotomy. I'm hoping that one had something to do with the other.

Perhaps your midwife can offer some suggestions?

Paula
Mom to Dante 8.1.02

[etwahl]

I remember being directed to a book for information and I don't see her again until Friday. I was also told at my hypnobirthing class sort of how to do it, but she suggested using extra virgin olive oil...sheesh!

Where would I find an internal fruit oil? How do I know it's for internal use? I'm just so not into this :( but I know that it will be very helpful to help avoid those tears and episiotomy, so I know I must!

Tammy,
Mom-to-be Mar 8, 2003!

[gour0]

Huh! I didn't even know you should do this yourself! I thought it was just something they during labor. Sigh. One more thing to look into... Anyone else ever get tired of the constant research?

[mamahill]

I kept putting off starting this and then Ainsleigh came early. I tried once to do it myself but it was just too awkward around the huge belly. Do you kow if your OB/MW will assist you at all? My nurse massaged for me as I was dilating/pushing. Also, warm washclothes applied at the rim REALLY helped. But then as it turned out we had to go with the vacuum (A's heartrate was having trouble), so an episiotomy was inevitable. And, FWIW, a friend of mine was VERY strict in doing the massage and then she had to have an episiotomy anyway. Someone else I know only had help in the delivery room and didn't tear at all. So if you're not into it, don't stress about it. Concentrate on relaxing now!

[etwahl]

I believe they will massage this at the time of delivery, but everyone I know has told me to start early and it will make it stretch more easily. I told my midwife about the crockpot and applying warm cloth with oil to the perineum at the point of crowning and she is totally fine with that. I just need to bring the crockpot (I'm going to need a forklift to get all my stuff into the hospital, never mind where to put it in the very small rooms they have!)

What kind of oil and how much should be used in the crockpot at the point of crowning? How exactly is it done properly?

Tammy,
Mom-to-be Mar 8, 2003!

[Rachels]

There are mixed schools of thought on this. It's sort of a common midwifery thing, but it hasn't been conclusively demonstrated to be helpful. If you feel anxious, I'd skip it. Anything you can accomplish by massage stretching doesn't hold a candle to what happens when you push out your baby's head. The last thing you want is to develop an anxious association to perineal pressure, because it can lead you to clench up during birth, which makes you more likely to tear. Your body stretches like crazy to grow your baby without your doing any practice, so it makes sense that you could deliver without doing massage first if that idea scares you. The best things you can do are 1) to give birth upright, semi-reclined, or on hands and knees, all of which can increase the diameter of the birth canal up to 30% over lying on your back, and 2) to not let anyone coach you on when to push. Sustained, directed bearing down (as in counting to ten for each push and pushing three times per contraction) is among the practices which have been specifically listed as "harmful and should be eliminated" by the World Health Organization. If you push only when your body tells you to, you will naturally be gentle and will ease your baby's head out with plenty of time to stretch. I did this and had no episiotomy and no tears, and I am in good company on that one. HTH!!

-Rachel
Mom to Abigail Rose
5/18/02

[etwahl]

Wow this is very good news Rachel. I'm assuming you didn't do the massage then? It's something I REALLY don't want to do, so I like what I'm hearing.

Also, can you give me instructions on what to tell the midwife about how to apply the warm (or hot?) compresses with oil from the crockpot?

Tammy,
Mom-to-be Mar 8, 2003!

[suribear]

my midwives will do perineal support during labor - oils, compresses, gentle pushing - to try to avoid tearing. I hear massage is more for your comfort than anything else (during labor) IF it feels good to you, that is!
i've heard mixed things about perineal massage before labor. i'm like you, Tammy. i'm really squeamish, so i don't think i'll do it beforehand.

Kris

[Rachels]

Nope, no perineal massage for me before labor, and no perineal trauma during the birth. Basically with the crockpot and oil, the midwife filled the crockpot and kept a number of soft washcloths in there with warm water. Then when Abigail's head began to crown, she held the warm cloths against my perineum and supported me while I pushed Abby's head out. It was heaven. Crowning is...um...pretty intense, and a good, very warm cloth really, really mitigates the discomfort. She also had some olive oil in a squirt bottle, and just sort of squirted me down right before her head began to show. It greased the chute. VERY helpful and wonderful, both.

-Rachel
Mom to Abigail Rose
5/18/02

[mcmorfit]

Eh gads, I totally forgot about this!

I need to ask my MW. I know at our hospital they have hot tubs/birthing tubs, so when I asked about it in child birth class, the nurse said that the tub does the same thing.

Thank you for the crock pot suggestion.

Ellen
EDD: 2/23/03

[stillplayswithbarbies]

Are there any websites or books that can tell me how to do this?

...Karen
Mom to Jake age 12 and expecting Logan Elizabeth or Logan Bartholomew, EDD March 21

[Melanie]

Instead of this, I took 45 minute skin-temperature baths, daily, for last 4 weeks. Followed by squatting (with furniture to lean/hold on to for support) for a few minutes.
Then the nurse did the massage while I pushed. No tears, just "skid marks."

Mommy to Jonah

[etwahl]

What are skid marks?

Tammy,
Mom-to-be Mar 8, 2003!

[Rachels]

Sometimes the baby leaves tiny abrasions on your perineum as it is born without actually tearing the tissue. These are called skid marks. They don't require suturing and heal pretty quickly, although they sting. They don't cause any major trauma, though.

-Rachel
Mom to Abigail Rose
5/18/02

[mama2be]

Tammy, I think these are why you use the squirt bottle after you deliver when you need to pee. That was some advice I got to make certain that you had alittle spray bottle of sorts to spray yourself and keep the pee sting away from these...

[etwahl]

Is it just water (warm water?) that you squirt? Do you squire before, during, or after? It's all so confusing!!! I'll have to remember to bring my squirt bottle to the hospital. Also, Do those Prep H cloths go right on top of the pad afterwards? Or does that mess up absorption?

Tammy,
Mom-to-be Mar 8, 2003!

[newbelly2002]

As to the bottle. . .

The hospital should give you one. I had no idea I would need it (although after seeing it I remembered my Mom having a ton of them around the house after my sister was born. NOW I know why!). I took the hospital's home as a "freebie." I would suggest buying another one or two and keeping them in your purse/diaperbag for when you're out and about in those first few weeks. I always squirted after, to avoid having to use tissue paper. It's not a friendly thought, believe me. I was sore in place I didn't even know existed.

One other thing that no one has mentioned is the "sitzbath." Forgive me if I am more graphic than is comfortable, but it was really amazing to me(again, something I remembered seeing as a kid in our house post-birth. And I thought they were all toys back then. If only I knew. . .). It's a small butt-sized tub that you fill with water, place on the toilet, and plunk your rear into. You refill it using a small hose and a bag of warm water and it drains into the toilet. You're supposed to sit in it for 20 minutes a few times a day. The nurse made me use it and told me she would come back in 20 minutes. I told her, no way was I going to stay sitting and still for 20 minutes. Teh thought of sitting on the toilet in a bowl of water sounded terrible to me. I assumed she'd come back and I'd already be up, dressed and back in bed cuddling with the babe. When she came back all I could say was "already??" It felt wonderful. Unbelievably wonderful. I took one of those home and while it was difficult to steal 20 minutes for myself a few times a day, when I did, it was heaven (ohh the things I consider a luxury now as oppose to pre-baby!).

Can't speak to the pads, I wish I had known about them.

Paula

[Rachels]

I squirted during. It made an enormous difference!

-Rachel
Mom to Abigail Rose
5/18/02

[etwahl]

I assume we then have to drip-dry? All I can say is it's a good thing we women have these babies and not our DH's...

Tammy,
Mom-to-be Mar 8, 2003!

[gour0]

All I can say is it's a good thing you don't find out all this stuff until its too late to change your mind!