Perineal Massage
From 34 weeks, it’s a good idea to start practicing perineal massage to prepare for the birth of your baby. The perineum is a triangular muscle between the vagina and the back passage that needs to stretch to make space for your baby.
Massaging this muscle during pregnancy can help it stretch more easily and reduce the risk of tearing. Other ways to reduce the risk of tearing include using a warm compress during the second stage of labour as the baby’s head advances.
Your midwife may ask for permission to place a hand on your perineum and the baby’s head to ensure the head is delivered slowly, helping to reduce the risk of tears. If you’re planning a water birth, the midwife cannot guide the baby’s head in this way, which slightly increases the risk of tearing.
If the midwife is concerned about a potential severe tear, an episiotomy may be recommended. This is a small cut made on the perineal muscle, and your consent will always be sought before it’s performed. Local anaesthetic is used to numb the area before the procedure.
In cases of significant tearing that involve the anal sphincter, a spinal anaesthetic is usually recommended. This is similar to an epidural, where you remain awake but completely numb, allowing a surgeon to repair the muscle and sphincter effectively.
For more information about perineal massage during pregnancy, visit the Trust website, where you can find the information leaflet.