Just the words ‘perineal trauma’ make me do some pelvic floor squeezes! Which is actually one of the things which can be helpful when you're preparing to give birth…
Statistically during labour you’ve basically got a 50/50 chance of sustaining some damage to your perineum. There are, however, a few things that can tip the balance in your favour of ending up in the half of women and birthing people who don’t need repair work after your baby is born. So what have three peas and a glass of water got to do with anything?
- PERINEAL MASSAGE! set the scene as you would for any massage, warm, comfortable, low lighting, privacy - even snacks and music if you like! Select a suitable massage oil – it’s your choice whether to buy an expensive one designed for the job or any edible oil or lube - and follow the simple instructions you can find online (the NCT website is good).
- POSITION! The position you are in for the birth of your baby, and importantly the ‘crowning’ of their head, is crucially important when it comes to avoiding a tear. If you’re on your back then the weight of the baby’s head is directly pressing on your perineum. Flip over to an all-fours, squatting or kneeling position – anything where gravity is helping the baby to descend away from the perineum, and you’re less likely to sustain damage.
- PELVIC FLOOR EXERCISES! Doing these throughout pregnancy to tone the muscles of the pelvic floor is helpful when it comes to giving birth – and also being able to recognise those muscles and knowing how to relax them and allow your body to push your baby out is equally important.
- WATERBIRTH! The research on this is mixed but on the whole seems to suggest that although you can still tear in water, it’s less likely to be a serious tear. Which makes sense if you think about the softening effect water has on skin… plus it’s easier to change position and get comfortable in water – which is all good!
If you have done all of the above and are still unlucky enough to sustain some damage down below, hopefully you’ll have reduced the likelihood of it being too serious and your midwife will be able to stitch it in the room you’ve given birth in. But even if you do need to transfer to a theatre for more extensive repair work remember that by then you’ll have your baby in your arms – or your partner’s arms close to you – and you can continue to gaze at them throughout (as well as using breathing or gas & air and having anaesthetic)!