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Perineal Massage

A recent review of trials of manual perineal massage during the last weeks of pregnancy (Kuehn 2006) has concluded that this technique can help prevent tears to the perineum in first time mothers and reduce the need for episiotomies during normal vaginal births. The reduction is not large (15%) and no doubt is also dependent on the practitioner in charge of the birth (other research has shown that midwives have a better track record than doctors in maintaining an intact perineum) but it is encouraging. Many women hope to have no stitches at the end of the birth day and it is also a goal for many midwives, who see perineal management as a key professional skill.

Of course, not all births will result in no tears, even if great care is taken. Some babies decide to arrive with a hand or arm over their heads; others rush out, leaving little time for the tissues to stretch. Anaesthetics and drugs that upset a woman’s ability to stay in touch with what is happening in her body can also make it hard to give birth slowly and gently, especially if the perineal area is numb and there is no feedback to work with.

Many women are interested in using perineal massage in the last weeks of their pregnancy. A useful place to learn more about this technique can be found on this site sponsored by the University of Michigan.

Some women find that using the Epi-No is a good way to prepare their perineal area for birth. This useful tool can also be used for strengthening the muscles after the birth, to reduce postnatal (and menopausal) incontinence problems due to poor pelvic floor muscle tine. There are more details about the Epi-no here.

Kuehn B. Massage during last weeks of pregnancy reduces episiotomies during delivery. JAMA 2006; 295:1361-1362.

Posted by andrea at August 10, 2006 05:26 PM