I think I should clarify what perineal massage means. Some refer to massage done prenatally to make the perineum more stretchy. Others refer to massage done just as the baby's head is being born. I've heard it also referred to as "ironing" the perineum (who would want their perineum 'ironed'?). In spite of the positive things the current research is saying, I have to say I must question the practice of massaging the perineum.
Leilah McCracken, author of the new book "Resexualizing Childbirth: A collection of essays," writes:
"Perineal massage is a very intimate touch that some people consider to be fundamental in ensuring a woman doesn't tear in her birth process. But practicing perineal massage so the vagina doesn't tear- and then claiming the massage prevented the tearing from occurring- is much like praying every morning for the sun to come up, then when it does, attributing the rising of the sun to the ongoing morning prayer sessions. Just like the sun will come up without human provocation, vaginas will stretch without human manipulation- just as they have done for millennia. Just as the vaginas of all other species have done for millennia."
What can be done to help women keep from tearing? Are we naive to think that simply massaging the perineum as a baby's body emerges is going to prevent tearing? In my experience of being present at over 3,000 births in my nursing career, here are my suggestions on what can be done to prevent perineal tears:
1. Good maternal nutrition-when a mother is well nourished, her tissues are in good health and are less likely to tear. Even when they do tear, they tear minimally and heal faster than women who are poorly nourished.
2. Warm perineal compresses-they can provide comfort and ease stretching for some women. Why do you think someone was sent to boil water in all of those movies where women are giving birth anyway-maybe it was to boil instruments, I like to think it was for warm compresses.
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