How to reduce the risk of perineal tears without perineal massage

There are many reasons why people don’t want to do perineal massage. If you don’t want to do a perineal massage, for whatever reason, that’s 100% okay!

Please understand that by not doing it doesn’t mean you are going to tear. If you do want more info on perineal massage check out this blog.

There is so much that you can do to prevent trauma to your perineum either during pregnancy or during childbirth.

While you’re pregnant:

1. Pelvic floor exercise

   Depending on the individual, pelvic floor exercises could include strengthening, learning to relax or coordination exercises. . The pelvic floor muscles must release, relax and lengthen to allow your baby’s head to descend through the birth canal. This skill can be taught and practised before labour. We recommend you practise in a variety of active birth positions

2. Prepare your body

   Preparing your body for birth is essential. exercise - improves circulation -> improves skin elasticity allowing for stretch orgasm - increases blood flow to vagina and perineum which improves tissue health ( plus it’s fun ) eat a healthy diet rich in Vit E, Vit C, zinc and collagen to help with recovery after birth.

3. Mobility exercises

   A regular mindful movement practise can be helpful in creating length in your pelvic floor and releasing stress and strain from the joints of your pelvis. Check out this post for some of our favourite exercises that can help prepare you for labour.

During childbirth:

1. Birthing position - move your body

   It is well understood that the best birthing position is the one that is instinctively chosen by a person in labour. The positions that have been shown to put the least amount of stress on the perineum.

   • All fours (hands and knees)

   • Leaning forward in supported standing and kneeling

   • Lying on your side - this has been shown to put the least amount of stress on the perineum.

2. ‘Breathe’ your baby out

   Breathing and bearing down with your contractions allows your baby to descend slowly down the birth canal. The slow descent minimises trauma to the pelvic floor.

   • Avoid coached pushing if possible

   • Avoid holding your breath - try loose ‘horse lip’ breathing instead

   • When it comes to the ‘ring of fire’ aka crowning the perineum and labia are stretching giving a burning or stinging sensation - relax and breathe, don’t bear down. Little puffs can also be helpful here.

3. Talk to your Birth provider

   Talk to your birth provider about ways in which they can reduce the risk of tearing during childbirth.

   1. Warm compress

      During the crowning phase, a warm compress on the perineum can reduce severe tearing. Lowers the risk of episiotomy. Helps the muscles of the perineum to stretch naturally. Some find this comforting, others prefer a hands off approach.

   2. Slow descent of baby

      Some birth providers have been trained to slow and control the descent of the baby during the final part of stage 2. This has been shown to reduce the risk of significant tears.

   3. Soft tissue massage

      perineal massage techniques during vaginal delivery decreases the risk of perineal trauma.

If you have any questions our team is here to help.

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no practitioner/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.