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The Perineum and Pregnancy

Tips to Help Avoid Injuring the Perineum During Childbirth

By Teri Brown

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It's important to remember that perineal massage does not lengthen the tissue, but it does increase the stretching capacity because of the oil used in the massage, which lubricates the skin, and by making the mother very aware and familiar with the area that will be stretched during childbirth. Familiarity with this area can help her keep the perineum relaxed at the right times during childbirth.

Clement agrees with this assessment. "It does allow a woman to become more familiar with her body and in particular an area with which she needs to be familiar with for when it is time to push out her baby!" she says.

Most natural childbirth experts believe that while the benefits may be minimal, perineal massage can certainly do no harm. Others aren't so sure.

Dr. Lillian Shapiro, OB/GYN and women's health expert, believes that there is a chance that perineal massage could possibly damage muscles. "Some people recommend perineal massage before labor," she says. "There are two primary concerns with this. One is that the vaginal tissue which must be pressed for perineal massage is delicate and easily torn. You do not need to start into labor already sore. The second issue is that the baby's head is about the size of a softball."

How long do you want your vagina to be stretched to the size of a softball? Dr. Shapiro asks. "If you over-stretch it for too long, you might have a much more difficult time with recovery," she says.

Most birth attendants recommend starting perineal massage in the last month or so of pregnancy, and doing it at least once per day from then on. The massage may hurt a little at first, so it is helpful to start out stretching the area for less than a minute and work up to a minute or more.


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