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Avoiding vaginal damage

Most women, understandably, do not like the idea of their vagina or perineum (the area between the vagina and anus) getting torn or cut during birth, and therefore needing stitches put in afterwards.

In Week 5, we will tell you all the things you can do during labour and birth to reduce the chance of a tear, or needing an episiotomy (a cut made in your vagina). But, before that, you need to know what you can do in pregnancy as well.

As you get near the end of pregnancy, your hormones increase. You will find that your pelvic joints get a little loose, and your muscles and tissues will relax and become softer. This is your body’s way of making sure that your pelvis and vagina will stretch and open up to allow your baby out. You can help your vaginal muscles to relax and become even softer and more stretchy if you do “perineal massages” during the last month of your pregnancy.

A review of four trials, including a total of 2497 women, showed that if women, or their partners, did perineal massages twice a week from 35 weeks until the time of birth, it reduced the likelihood of damage to the perineum, including episiotomies and reduced pain (Beckmann, 2013). They are particularly helpful for first-time mothers.

It sounds a bit scary…

If you are nervous about doing this, try sitting in a warm bath for a while before you start. This will relax you and will also loosen the muscles around your perineum. It might be a good plan to cut or trim your nails before you start as the lining of the vagina is easily cut or scraped. If you don’t have a bath available to you, have a shower instead.

How do I do it?

Get yourself comfortable, probably in bed, propped up on a few pillows with your knees bent. You will need some olive, sunflower, or vitamin E oil (plain, natural oils). It is more comfortable if it is warmed slightly so put a little in a saucer on the radiator while you have your bath/shower.

Dip your thumbs in the oil, shaking any excess off, and insert both thumbs slowly and gently into your vagina. Press down gently towards the ground and out to the sides of your vagina. Hold your thumbs like this for about one minute - you can listen to music or watch a programme while you do this. You will begin to feel a stretching, slightly burning sensation. Breathe gently and relax until you feel the sensation getting less.

Gently massage the lower part of your vagina in a U-shaped movement for about 2-3 minutes. Relax for a moment or two, and then repeat 2-3 times. The whole massage will be done in 10-15 minutes. Your partner can do this with you, if you like.

How often do I need to do it?

Aim to do a perineal massage every second day, but definitely twice a week. Every week, as you get used to the feeling of the massage, increase the pressure a little so that you always feel a little burning and stretching. Teach yourself to relax when you have that feeling – it will help you a lot when your baby’s head is being born.

How will I know it’s working?

You will feel the tissues becoming more stretchy as the weeks go by, which should give you more confidence in your body’s ability to birth. But the main benefit is that you will become more familiar with your body and the sensations that you will next feel when your baby is moving down, ready to be born.

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This article is from the free online course:

Journey to birth

Trinity College Dublin