From fear of episiotomy to small tear at delivery
Rosemary* was 34 weeks pregnant with her second baby when she contacted me. She had heard that in my practise as a midwife I had been trained in many aspects of complementary therapies. All her scans, blood tests had been in normal limits. She had no problems during her pregnancies and she had no previous medical or surgical problems.
Her first baby was a forceps delivery, after having had a medical Induction of Labour (IOL) at 41weeks +11 days and she was eager to avoid another episiotomy. She had experienced lots of perineal pain after her last birth and this had lasted for many months, affecting her relationship with her partner.
I explained there were many studies on perineal massage during pregnancy, which have shown there were less tears to the perineum, if you massaged this area from 34 weeks of pregnancy. As she had the previous episiotomy scar, massaging the perineum to make this area to have more stretch, would give her more confidence to deliver her baby.
She agreed to try it, especially as she also wanted to have less perineal pain after the birth and wanted to avoid tears. I blended carrier oils (vegetable) and no essential oils, as this is a very sensitive area. I also gave her a leaflet on ‘How to massage the perineum’, as it is important to massage correctly. When she left me she was very enthusiastic to massage ‘Down Below’ with the oils I had blended.
Contact after the Birth
I phoned Rosemary at home when her daughter was 3 weeks old. She was delighted to talk to me. She had a normal birth with just a small tear, that didn’t require any stitches. She felt that the whole experience had been totally different and wished she had massaged her perineum, when she was pregnant with her first baby. She was very pleased, as ‘Down Below’ was a great improvement from last time, enabling her to enjoy her daughter.
*Name changed to protect confidentiality
Please inform the midwife or doctor, when you are using complementary therapies.
I used a blend of Jojoba
vegetable oils (carrier) and these were suitable for a perineal (perineum) massage in pregnancy. Their effectiveness and quality were specifically blended to massage the perineum. Apricot
oil is quickly absorbed into the skin and is an amazing nourishing moisturiser. Jojoba
is compatible with the skin due to its likeliness to the skin’s oils and therefore it can penetrate deep into your skin giving the skin more elastacity
Jan Bastard BSc. (Hons) complementary therapy/aromatherapy, RN, RM, Anaesthetic Diploma, IAIM.
Kettle, C., Tohill, S. (2008). Perineal care BMJ Clin. Evid 2008:1401 (online).
Beckmann, M. M., Garrett, A. J. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst. Rev. 2006 Jan 25 (1).
Do not use perineal massage, if you have an infection “down below”.