Episiotomies: An Overview

Perineal Massage

Do this exercise daily beginning approximately the 32nd week of pregnancy.

1. Trim your fingernails and scrub your hands.
2. Sit in a warm comfortable area, spreading your legs apart in a semi-sitting birthing position.
3. Prop a mirror in front of your perineal area, facing inwards.
4. Use massage oil, such as pure vegetable oil, or a water-soluble lubricant, such as K-Y Jelly (not a petroleum-based oil) on your fingers and thumbs and around your perineum.
5. Insert your thumbs as deeply as you can inside your vagina and spread your legs. Press the perineal area down toward the rectum and toward the sides. Gently continue to stretch this opening until you feel a slight burn or tingling.
6. Hold this stretch until the tingling subsides and gently massage the lower part of the vaginal canal back and forth.
7. While massaging, hook your thumbs onto the sides of the vaginal canal and gently pull these tissues forward, as your baby's head will do during delivery.
8. Finally, gently massage the tissues between the thumb and forefinger back and forth for about a minute. Being too vigorous could cause bruising or swelling in these sensitive tissues. Avoid pressure on the urethra as this could induce irritation or infection.

Kegel Exercises

To do a Kegel, tighten the muscles around the vagina and anus and hold for 8 to 10 seconds about 200 times a day. Confused? Practice stopping a stream of urine when you're on the toilet.

Kegels provide many benefits:

• They can help prevent leaking urine when you sneeze or cough.
• Conditioned muscles will make birth easier, and your perineum will more likely be intact (fewer tears and episiotomies.)
• Sexual enjoyment is enhanced for both partners.
• It can prevent prolapses of pelvic organs.

Pain Treatment

If you are suffering from an episiotomy or tearing pain, ask your doctor for pain medication or try some of these natural remedies:

1. Sitz baths. Fill your tub a few inches with warm water.
2. Special pads that have ice packs built in.
3. Peri care. This means that you wash with a squirt bottle as opposed to wiping. Patting dry is also better than wiping.
4. Using Tucks® has been recommended; you can make your own with witch hazel and pads.
5. When resuming intercourse, you may want to use a personal lubricant such as KY Jelly®.