Giving birth is one of the biggest challenges in a woman’s life. If you have ever trained hard for an upcoming event like a triathlon you would know that in order to be successful you are required to match the distributions you will be experiencing.
What is a perineum? And why should I protect it?
Your perineum is the area between your vulva and anus. It helps support the uterus, bladder, and vagina. The reason you need to protect this area in birth is because when there is trauma to this area it can cause a lot of pain and many other problems that will be described below.
Depending on where you are in your pregnancy you may have been told to do a perineum massage. This is when you put your fingers inside your vagina and try to stretch the perineum. Why do the doctors or midwives tell you to do this?
First-degree perineal tears are the least severe. They may or may not require stitches. I had one minor tear inside of my vagina because my daughter came out with her arm up above her head.
Second-degree perineal tear involves tearing the perineal muscles. These muscles support the bladder, vagina, and uterus and will require stitches to the perineum.
Third-degree perineal tear involve the perineal muscles and the muscles that surround the anus. A consequence of this type of tear is faecal incontinence, urinary incontinence, and painful intercourse.
Forth-degree perineal tears are the most severe and they involve the perineal muscles, the anal sphincter, as well as the tissue lining the rectum. Consequences of this type of tear are also faecal incontinence, urinary incontinence and painful intercourse.
A lot of women tell me “I wish I would have known about the consequences of tearing my perineum or getting an episiotomy and that there was a way to prevent it”
In order to train your perineum and pelvic floor you will need to gradually strengthen and stretch the muscles and tissues so it will become stronger and more elastic. This will reduce the chance of a tear of the perineum or the need for an episiotomy during delivery. If the perineum remains intact, the muscles and tissue can easily recover following birth. And scars, prolapse of the organs, and incontinence can be avoided.
There is a birth trainer specifically for this. It is called the EPI-NO Delphine Plus. A Birth and Postnatal Trainer, designed, developed, and manufactured in Germany in close co-operation with gynaecologists, midwives, urogenital physiotherapists and pregnant women. It is also is Health Canada approved! If you have extended health benefits you may be able to use them to purchase the EPI-NO.
The training methods that are used with this device is a three stage program:
- Exercise your pelvic floor muscles to strengthen them before birth,
- Stretch the perineum, for the gradual stretching of the vaginal passage, the perineum and the vaginal muscles before birth, and
- Simulation of birth to train for the delivery phase of childbirth.
Arco Maternity Clinic Recommendations for Use:
- It is recommended that you train daily from your 36th week of pregnancy, optimally 2 x a day in a relaxed and undisturbed atmosphere.
- Preheat the perineum with a warm damp compress, a hayseed pack, or a hip bath.
- Training time not less than 10 min, according to the instructions for use, daily increase the diameter of the balloon by inflating right up to the limit where a feeling of tension is noticeable.
- Breathe deeply several times into this tension, close your eyes and visualize the little head of the baby, then press the balloon slowly out of the vagina.
- The training is recommendable for all pregnant women, whether expecting a first child of after several births, whether there was once a birth with the perineum intact or a perineal tear or episiotomy.
Just like a triathlon you need to mentally prepare yourself. The simulation of birth allows you to experience the sensation ahead of time, giving you more confidence and lessening any anxieties, which in turn will help you to relax.
Experiences with the EPI-NO from the Arco Maternity Clinic:
“Each midwife learns and knows the active form of perineum protection, for many midwives it is a privilege to be active there where the child arrives and to avoid a rapid passage of the head and thus possible injury to the perineum. We midwives from the arco Maternity Clinic go so far as to say that an active protection of the perineum by the midwife is, after training with EPI·NO, no longer necessary. There is nothing more wonderful and fulfilling for the woman giving birth, her partner and for us midwives than for the woman to push the little head of her child with her own hand or the hand of her partner. She knows herself intuitively also through the training with EPI·NO, how much feeling and dosing this procedure requires. These births are the ones with the fewest perineum injuries and it is the most dignified, active and integral way to accompany a birth. To experience woman and man as an entity, we midwives remain in the background as extras who can call on their professional knowledge at any time and whenever necessary.”
The finish line of your “Triathlon of Birth” is the most magnificent and life-changing time of your life, and a successful triathlon of birth should involve your family, friends, doula, and physician cheering you on.
I wish you success in your pelvic health!
The Brilliant Baby Bump is a Medicine Hat company devoted to education, prevention, and healing women in their pelvic health. We are dedicated to raising awareness in women’s pelvic health to prevent pelvic floor dysfunction. We want to create a community where women are not embarrassed to talk about pelvic floor health. http://www.brilliantbabybump.ca