Medical pure and organic almond oil that is recommended
for perineum massage for about two months before giving
Starting around the 34th week
of your pregnancy, try daily prenatal massage of the
perineum (the area around your vagina). Perineum
massage may increase the stretching ability of the
area, decreasing the chance of an episiotomy and
less chance of natural tears. (There is no medical
evidence that this technique avoids an episiotomy,
but it can't hurt if you want to try).
With clean hands and trimmed nails, try this
technique yourself, or have your partner do it for
you. Tip: If you do it yourself, use a mirror to
help familiarize yourself with your perineal area:
Sitting in a warm
comfortable area, spread your legs apart in a
semi-sitting position. Use a medical pure sweet
almond oil , put a small amount on your fingers
and thumbs and around your perineum.
Place your thumbs about 1
inch (or just past your first knuckle) inside
your vagina and spread your legs. Press down
toward the rectum and toward the sides at the
same time. Gently and firmly continue stretching
until you feel a slight burn or tingling.
Hold this stretch for
about 2 minutes, or until the tingling fade.
Now slowly and gently
massage the lower part of the vaginal canal back
and forth, hooking your thumbs onto the sides of
the vaginal canal and gently pulling these
tissues forward. This is what your baby's head
will do during delivery. Continue for 3-4
Finally, massage the
tissues between the thumb and forefinger back
and forth for about a minute.
Do be gentle, as a
vigorous touch could cause bruising or swelling
in these sensitive tissues. During the massage
avoid pressure on the urethra (urinary opening)
as this could induce irritation or infection.
Perineum massage is not for everyone and it may not
help in every case. So, the most important thing you
can do is to choose a midwife or doctor who is
experienced and comfortable delivering babies
without cutting an episiotomy. Discuss with your
doctor what your expectations and choices are should
in advance so that when the time comes they can
follow your wishes.
What are the advantages and
disadvantages of an episiotomy?
As with everything there are disadvantages and
advantages to an episiotomy. An episiotomy is the
most common operation in obstetrics; in many
hospitals, a majority of first-time mothers get
It has long been thought that episiotomy prevented
trauma to the perineum and improved the long-term
function of the pelvic musculature. However, recent
studies have shown that this is simply not true.
Episiotomies do not prevent pelvic floor relaxation
and do not prevent serious perineal damage. In fact,
research shows that midline episiotomies tend to
increase the average depth of perineal injury and
substantially increase the risk of damage to the
anal sphincter and the rectum (which can cause a lot
of discomfort and, at times, long-term problems,
such as anal incontinence). Besides increasing the
incidence of serious lacerations, episiotomy is
associated with increased pain postpartum, increased
sexual discomfort when intercourse is resumed, and
increased blood loss at the time of delivery.
Some women who do not receive an episiotomy will end
up with spontaneous perineal lacerations, but
studies show in general, these women also experience
less pain after delivery and stronger pelvic floor
musculature at three months postpartum than women
who underwent episiotomies.
There are times when performing an episiotomy can be
justified. Delivering a baby over an intact perineum
requires slightly more time during the second stage
of labor (the pushing stage), as the midwife or
doctor must allow adequate time for the mother's
vagina and perineum to gradually stretch.
Occasionally, the fetus simply cannot tolerate the
extra time needed for the vagina to stretch
naturally, and an episiotomy is used to expedite
Episiotomy is also common when more room is required
for manipulation, such as for a vaginal breech
delivery or the delivery of a very large infant.
Plus an episiotomy is often performed before the
application of forceps or a vacuum extractor. On
rare occasions, the maternal tissue is either so
swollen or otherwise compromised that it cannot
stretch well and episiotomy is needed.
If you'd like to avoid an episiotomy, it's important
to speak to your healthcare provider early on about
your feelings regarding the procedure. Also, ask
your care provider about her experience delivering
babies over intact perineums and the episiotomy rate
in the practice.