How to prevent a tear during pregnancy
Some people have heard of perineal massage as a way to help prevent tearing during labor. Some research shows that perineal massage might help prevent tearing, while other research has shown that it does not have much of an effect.
Perineal massage is when the skin of the perineum (area between the vagina and anus) is massaged by applying pressure with your thumb or finger to stretch the skin. Yes, this is a layer of tissue that can tear during delivery. But, you know what else might tear? The muscles.
For years, I have been guiding my clients to perform pelvic floor muscle stretching/lengthening during pregnancy. If they can stretch the pelvic floor muscles consistently for about 2 months prior to delivery, they seem to have significantly less tearing of both the skin and the muscles. Some physical therapists have even found that stretching the pelvic floor muscles consistently in the third trimester has led to shorter active labor times.
As long as you have a healthy pregnancy, and you get the okay from your birthing team, there are minimal to no side-effects of stretching the pelvic floor muscles. Basically, if there are no side-effects and there could be some benefits, why not try it?
Well, speaking from experience, it is not as easy has it sounds. You have to make sure that both you and your partner have time because in the third trimester of pregnancy your belly is just too big to massage the area by yourself. If you don’t want to do it with your partner then you need to take the time to go to a physical therapist and that means that hopefully there is a physical therapist in your area and they have availability.
I moved to Loveland during my second trimester of my pregnancy with my daughter. I knew the benefits of pelvic floor stretching during pregnancy so I immediately started looking for a pelvic floor physical therapist. I was unable to find a pelvic floor PT in Loveland who would do internal work on me while I was pregnant. I tried to have my husband do the stretching once my third trimester started, but it just was unrealistic since we also had a 1.5 year old to entertain.
Luckily, I finally found a PT 30 minutes away and started seeing her weekly. However, I did not find her until I was 32 weeks pregnant and only got to see her for 3 weeks. I noticed benefits of having my pelvic floor muscles stretched even from just 3 short weeks. I was able to have a vaginal delivery (something I was not able to do with my first pregnancy) and my active labor time was so fast we didn’t time it!
As the patient, I noticed an added benefit from the physical therapist stretching my pelvic floor muscles. By her stretching my muscles, I was more prepared mentally for the “ring-of-fire”. The “ring-of-fire” is what some people say to describe the feeling of the baby’s head entering the vaginal canal. I was familiar with this feeling from the pelvic floor PT work and I had practiced breathing into it. So, when I felt it during the delivery of my daughter, I was able to just breathe through it and deliver her quickly at home. If you are going for a natural birth, this is another benefit of stretching the pelvic floor muscles.
