Epi-No or Yes? Regardless, let's talk about perineal massage

Hi, I'm Karenna from Hope and Honey - offering childbirth education classes, HypnoBirthing, birth pool hire and much more in Perth, Western Australia. Here's my latest blog about perineal massage:

Ok don't get embarrassed, we're going to talk about something a little bit private but oh so important and something that should be more public.

When preparing your body for birth, many midwives and in HypnoBirthing we advocate you to practise perineal massage. Now this is a part of your body that you will probably never have paid any attention to before. It's the section of muscle inbetween your vagina and your anus.

During the birthing and crowning phase of labour this section of muscle is stretched to allow the baby's head through. Your perineum, with the correct preparation and care, will stretch and allow the baby through with no tearing or need for an episiotomy (medical cut). Just like preparing for exercise, we would stretch a muscle - we can also prepare our perineums for birth through gentle stretching.

Some women liken this phase of birth to have a stretching / stinging / burning sensation - but remember that every woman experiences this differently. At the time of birth, your perineum can be assisted in stretching through slow birthing / crowning, hot compresses and water births. Before birth (from approximately 34 weeks) you can also prepare this area by using your fingers to stretch the area. Inserting your or your partner's thumbs into the vagina at the bottom and stretching apart until you can feel the stretch, then holding it for a minute or two.

This has two benefits - firstly it will give you an idea what this sensation feels like and secondly regular massage in the later weeks will prepare the area to stretch easily and naturally. You can use natural oils such as sesame oil or vitamin e oil, but I wouldn't recommend synthetic or petroleum-based oils.

You can also talk to your midwife or OB about how they care for the perineum during birth.

Now there is also a product on the market to help you stretch your perineum - the Epi-No. As with anything there are supporters and opponents. The product uses a balloon and a pressure pump to facilitate stretching of the perineum up to 10cm (full dilation). The Epi-No can also be used as a pelvic floor trainer.

Opponents of the device say that you shouldn't really be stretching your perineum to this degree without all the accompanying natural labour hormones and lubrication that are present during birth. Supporters say it can reduce tearing and the need for episiotomies. Whatever your stance on the Epi-No, it's important to prepare your perineum.

So tell your friends and don't be shy to talk about it.

Feel confident in your body's natural ability to birth a baby and use your pregnancy to become informed, confident and practiced in the art of active and involved birthing.

Much love xxx

For more information and advice, why not sign up to Hope and Honey's childbirth education classes or HypnoBirthing classes?