Episiotomy and Pain
It's not difficult to figure out why pregnant women start
squirming when the subject of episiotomy is raised. After all,
the mere thought of having an incision made to one of the most
tender parts of your body - the area between the vagina and the
rectum - can have you rethinking this whole pregnancy thing.
And given that studies have shown that women who require
episiotomies are more likely to experience such post-delivery
complications as blood loss, infection, postpartum pain, pain
during intercourse and the involuntary passage of gas or fecal
material, you can see why most women are eager to do whatever
they can to sidestep this particular surgical procedure.
The Good News Department
Fortunately, there is some good news on the episiotomy front.
A study reported in the March 2000 issue of
Obstetrics and Gynecology demonstrated quite
conclusively that first-time mothers who practice perineal
massage (the stretching of the tissues surrounding the opening
to the vagina) for 10 minutes daily during the final weeks of
pregnancy are less likely to require an episiotomy or to
experience perineal tearing than other first-time mothers.
(Unfortunately, perineal massage doesn't appear to offer the
same benefits to women giving birth for the second or
subsequent time - bad news for the veteran moms in the
crowd.)
The Art of Perineal Massage
For best results, you'll want to start practicing perineal
massage about six weeks before your baby is due, and you'll
want to set aside about 10 minutes for each daily stretching
session. Here's what you'll need to know to get started.
Get comfortable. Some women find that soaking in a warm bath or applying warm compresses to the perineum for at least 10 minutes prior to the massage helps them to relax.
You can either do the massage in the bathtub or on a towel on your bed. (If you decide to do the massage on dry land, you'll need to use a water-soluble lubricant such as KY jelly, olive oil or vegetable oil.) Place your thumbs 1 to 1 1/2 inches inside your vagina and press downward towards the rectum as well as out to the sides. You will feel a slight burning, stinging or tingling sensation. Hold the pressure for about two minutes, until the area becomes numb, and then breathe slowly and deeply while you try to relax the muscles in this area. Then gently massage back and forth along the sides of your vagina, moving your hands in a u-shaped motion for three minutes. Relax and repeat.
One last bit of advice: Don't wait too long to get started. Practicing perineal massage during labor itself (as opposed to during the weeks leading up the delivery) does not appear to reduce the chances that a woman will require an episiotomy or experience a significant tear. This is definitely one of those situations where the early bird gets the worm (or, in this case, the intact perineum!)
About the Author: Ann Douglas is an award-winning pregnancy and parenting author. She is the author of The Mother of All Pregnancy Books, The Mother of All Baby Books, The Mother of All Toddler Books, The Mother of All Parenting Books, and The Mother of All Pregnancy Organizers (all part of the internationally best-selling The Mother of All® Books series), as well as the two debut titles in the newly launched The Mother of All Solutions series: Sleep Solutions for Your Baby, Toddler and Preschooler: The Ultimate No-Worry Approach for Each Age and Stage (Mother of All Solutions), and Mealtime Solutions for Your Baby, Toddler and Preschooler, Part of The Mother of All Solutions series: The Ultimate No-Worry Approach for Each Age and Stage (Mother of All Solutions). She is also the co-author of other highly popular titles in the pregnancy and parenting category, including The unofficial Guide to Having a Baby and Trying Again: A Guide to Pregnancy after Miscarriage, Stillbirth, and Infant Loss (both co-authored with John R. Sussman, MD).
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