Marsha Burnett is the founder of Ensant, a Skin Care line for Expectant Mothers. A mother of two, Marsha started her business in 2004 to help other women deal with the sometimes overwhelming prospect of birth and advising moms-to-be on ways to spend the 9 months wisely; encouraging women to prepare mind, body and soul for a positive birth experience. Marsha found that the most common concern was how their bodies would cope with the extreme changes. Marsha has prepared this guide to assist expectant readers of MetroplexBaby.com and our partner, BigCityMoms.com in minimizing tears and reducing the need for an episiotomy with perineal massage techniques.

Pre Natal Perineal Massage

Download Instructions For Perineal Massage

If you ask a room full of non members where their perineum is, chances are that only a few will locate it immediately. Ask the same number of moms or moms-to-be and you will get a completely different response. We are acutely aware of where it is & what it goes through during labor & birth.

Perineal trauma and episiotomy are thought to be par for the course amongst pregnant women. In 1979, the first year that national statistics on episiotomy were collected in the USA, the operation was performed in 65.1% of all vaginal deliveries. Today it is more like 32.7% of all deliveries.

When I became pregnant, I instinctively knew that I wanted to do something to prepare my body for what was coming. I knew for sure that I did not want an episiotomy, I would not permit anyone to cut me. But what could I do to prevent what was likely to naturally occur when birthing my child?

I understood that this amazing body of mine was made precisely for this purpose. That God does not ever burden us with more than we are equipped to deal with. Yet even with all of this knowledge, directly after all of the ‘normal’ fears, worries and doubts that I had for the well being of my unborn child, I feared tearing in two.

The problem wasn’t that I didn’t trust my body’s ability to cope, that I was short on faith, or that I lacked confidence in myself. I wanted to do something, be proactive, take part. I’d be in the kitchen and find my self rubbing olive oil into my burgeoning stomach or practicing Kegel exercises at stop lights for the same reason: an ounce of prevention, right?

While reading up on episiotomy, I came across a few references on Pre Natal Perineal massage. A technique used to slowly and gently stretch the skin around the vagina and perineum. Some women do this exercise in preparation for labor, starting a few weeks before their due date. This massage can help make your vaginal muscles ready for stretching during birth, minimizing vaginal tears and reducing the need for an episiotomy. And according to Dr. Sears:

The better you prepare your perineal tissues for the stretching of birth, the less they will tear, and the better they will heal. Like training muscles to perform at their best in an athletic event, conditioning the tissues around the vaginal opening with massage prepares the perineum to perform. Midwives report that women who practice perineal massage daily in the last six weeks of pregnancy experience less stinging sensation during crowning. Mothers with a more conditioned perineum are less likely to tear or get an episiotomy. An added value of perineal massage is that it familiarizes a woman with stretching sensations in this area so she will more easily relax these stretching muscles when stinging occurs just before the moment of birth. Excerpt from The Birth Book By William and Martha Sears

Knowing I wanted to try it, I researched as much as I could find on the topic and practiced administering the massage early in my pregnancy.  I wondered why information on this topic wasn’t readily available and discussed in childbirth classes, right along with c sections and epidurals?. The more we talk about it and reference the information, the more women will access it.

I have now had two babies with no tearing. I know that perineal massage isn’t the only reason for my intact perineum. A combination of a proactive approach to my pregnancies, my fantastic birth support team and great coaching at the critical moment all contributed to my personal result.

To quote the American College of Nurse Midwives (ACMN): “It is free, it doesn’t hurt, it is easy to do. And most women don’t mind doing it. My experiences have led me to become an advocate for perineal massage. I truly believe that given the information and encouragement, more women would try the technique. Whether it prevents tearing, just familiarizes a woman with the sensation of stretching or reassures the psyche, perineal massage has some very positive attributes.

MB 10/08/07