Perineal massage in pregnancy

I’m writing about perineal massage only because it was one of those things I was completely unaware of until I became pregnant, like skin tags (which I now have), freckles and dark pigmentation all over the breasts (which I also have) and swollen veins in the vulva (which I don’t have but heard about at yoga).

For the uninitiated, perineal massage involves stretching the area between the vagina and rectum to reduce the chances of tearing during labour. You can start from about 34 weeks, which is when the hormone relaxin starts to relax the pelvic ligaments and soften the cervix. The massage is thought to be most effective in first-time mothers (who haven’t already had an episiotomy or tearing) and in mothers over 30 (as our tissues are stiffer, sigh).

I will admit to being only vaguely aware of where my perineum was, so I wasn’t looking forward to this. I had my first stab last week, at 35 weeks, and I wouldn’t call it a complete success, which I’m sure is very common. You are advised to insert two thumbs, which I just couldn’t manage, despite having my leg raised on a chair. I used my middle finger instead and followed the instructions I’d been given by the hospital. You’re told that the first few times can cause a little stinging/burning but that this improves. What I wasn’t expecting was the milky white discharge oozing onto my oiled finger when I took it out. I was aware that there’s a lot more vaginal discharge towards the end of pregnancy but of course I wondered if I had done something wrong, which I intuitively knew I hadn’t but still… As someone who hasn’t been having sex during her pregnancy, I’m probably a bit more squeamish than others about this kind of thing. A quick Google search later on reassured me that I wasn’t the only one to be surprised by the amount of discharge and that it was perfectly normal.

At my next try, I went for the seated on the bed against pillows with legs raised position and used a hand mirror to get a better grip on what I was doing. This went a lot better, even if I felt as if I was at a women’s consciousness-raising event in the 1970s. I could feel a little bit of the burn but not too much and had a much better idea of where I was aiming for.

Having attempted perineal massage only three times in all, I’m still not sure if I’m doing it correctly but I’ll persevere. Only time will tell whether it’s worth the bother, unless of course I end up having a section.

36 week GP appointment

I was at the GP today and from now on will be seen weekly alternately by midwife or doctor. Dr B didn’t like the look of my swollen feet but my blood pressure was fine, so no alarm yet. There was a trace of protein in my urine, which is apparently normal at this stage and also nothing to panic about. I was measuring to term and the heartbeat was strong and fast. I had thought last week that the baby might have shifted to a crossways position but she reckoned he was still head down and that it was just his little bum I was feeling on either side of my abdomen. I’m not entirely clear on how they will know for sure which way he is lying when there is no scanner at either the GP’s or midwife’s clinic but I’ll take this as it comes.

I asked Dr B about raspberry leaf tea and evening primrose oil (EPO). I bought the tea, which is supposed to help get your uterus ready for labour, a couple of weekends ago and asked my midwife about it at my 34 week appointment. She cautioned that it made her blood pressure shoot up when she used it in her first pregnancy. Dr B also felt it was better to avoid the tea, having seen some patients have problems with it. I’m inclined to err on the side of caution because of my swollen feet and my tendency to white coat syndrome when it comes to blood pressure, so my box of tea will remain unopened. On the EPO, which the yoga midwife had said could be inserted vaginally to start softening the cervix, Dr B advised against inserting anything that you don’t have to for fear of infection, adding that perineal massage is an exception that appears to be worth the trouble. (We had a good laugh about vaginal radios – leave your unborn child a voice message, really??) Having bought the EPO, I might take it orally instead, will look into this.

I’m determined to get the last few to-do-list things like getting the car seat checked and attending a breastfeeding class sorted so I can relax and enjoy these last few weeks – as much as is possible with the feet of an elephant and the body of a moose.

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