What's My Perineum? Will It Tear During Birth?
One of the thoughts that is all too consuming when preparing to give birth to a baby is "Will I tear?". That skin down there, it's sensitive! How can you make sure to support your body and still allow a baby to come out of that space?
Enter the amazing perineum!
What is the perineum?
Your perineum is the muscle and tissue at the opening of the vagina, surrounding the area from vaginal to anus. It's pretty incredible and very tough! The perineum is designed to stretch, move and soften to allow a baby to emerge from the vagina, and then it's job is to (over time of course) move back into position. Muscle memory is an incredible thing!
How does it do this - and will it break?
Your perineum is strong, but a few other factors help to minimize damage to the tissues and tendons during birth. As your baby begins to descend and crown, its head's job is to slowly rock forward and backwards to stretch the tissue and allow it to begin expanding, slowly.
Listen to your body and allow it to push when it feels good, but don't overpower it! As your baby emerges, the stretching as baby stays in position between birth can help the elasticity and movement of the perineum. Your care provider can also assist, by using counter pressure, warm compresses and oils such as safflower and coconut oil during delivery to help lubricate and moisten the perineum to allow it to move carefully around baby's head.
Tearing
Tearing occurs when forceful pushing is applied during the crowning phase and birth of baby's shoulders. When you feel an incredible urge to push, ask your provider to tell you to stop pushing, or give little, short breaths (you will still push as a reflex, but your body won't do it forcefully!). This will allow them to support the perineum and fold it behind your baby's head and minimize tearing.
With all of this support, there is still a possibility a tear can occur, but with proper support, you can greatly diminish this risk!
Should I Do Perineal Massage To Avoid Tearing?
There has been much debate on perineal massage to help assist the perineum in stretching prior to labor and birth. The new general consensus is that while it MAY be helpful, it can't guarantee against a tear. It could also weaken the pelvic floor muscles that are helping to hold up and assist in final weeks of pregnancy, so go easy on the massage!
Perineal massage is useful in another aspect; it can help you understand the sensation of stretching that might occur when you are pushing. To many women, that feeling is alarming, and knowing what to expect might be helpful when the feeling crops up during birth!
Postpartum Care of the Perineum
After delivery, the perineum needs rest and support to recover and begin to move back to its original state. This takes a LOT of time, and I encourage you NOT to look down there for quite awhile! During this time, for the first 24 hours you will apply cold ice packs to the area, to reduce swelling from increased blood flow. Remember that your muscles down there worked hard - and they need some support to heal! Witch hazel and diluting urine with a peri bottle of warm water when you void your bladder will help with any sensitivity and repairs to avoid infection.
The body's birth mechanisms are quite amazing! Treat your perineum with care and it will be kind to you during birth!
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