Perineal massage Although they’re no longer done as a matter of routine, even the thought of an episiotomy can bring tears to your eyes so it’s hardly surprising that most women are keen to avoid tears, cuts and stitches during birth. This is not surprising, considering that a 6-10 pound little person has spent minutes or hours pushing her or his way against a woman’s delicate innermost mucus membranes. Fatal cases of herpetic infections have occurred in two patients on fingolimod.5 Recently, a case of varicella zoster encephalitis and vasculopathy has been reported in a VZV seropositive patient receiving fingolimod.6 Usually authors discontinue the novel therapy indefinitely and switch to another disease modulating drug. A perineal m age also familiarizes the mother with the stretching sensations she will feel as the baby is born. Apart from painful emergencies justifying immediate surgery, indications for surgery should be weighed in terms of the patient’s general condition, the stage of advancement of the disease and expected benefit in terms of patient comfort. Perineal massage can also encourage you to relax when you have a vaginal exam. The PERL report states, in regard to Kegel exercises, “Regular pelvic floor muscle exercises make the muscles that support your pelvic organs stronger and helps you use the muscles more effectively.
It can also be due to the powder used leading to dryness. * Perineal massage during labor helps to ease the tissues around the baby’s head as it is crowning and clearly benefits both mother and child. Acute female genital ulcers, occurs in young women. Better flow of blood and oxygen to the baby, so less fetal distress. This polymicrobial synergistic infection spreads rapidly along the fascial planes and has a fulminant clinical course . If done by the woman The first few times if may be useful to use a mirror and try to find a comfortable position. Better sense of satisfaction and accomplishment.” Spontaneous pushing is a type of pushing that uses the woman’s inner responses to the movement of the baby through the birth canal to indicate when pushing should begin, rather than relying on fetal heart monitors or caregivers.
An editorial in the Lancet (January 22, 2000) demonstrated that perineal massage may help to prevent damage to the vagina and rectum during the birth process. 33-54). This can cause painful intercourse, loss of control of urine or stool, and persistent pain in that area. Five studies show that perineal massage helps to prevent tearing of the vagina during childbirth, particularly during the first childbirth. Well, the stinging I felt wasn’t just from the cut, but from a little white patch one of my labia minora (the inner folds). This procedure helped prevent tearing of the vagina and rectum primarily in women who were having their first childbirth. We tried to do this every day.
Perineal massage involves gently stretching the tissues that surround the opening to the vagina. The perineum is the area of skin between the vagina and rectum. Perineal massage may make tears or an episiotomy less likely; may reduce the stinging sensation during crowning, and familiarize laboring women with the stretching sensations of birth to enhance relaxation. Do this for 3-4 minutes. Perineal massage is not appropriate for some birth professionals to demonstrate on their clients, as this is clearly outside of their Scopes of Practice. It is usually done for 10 minutes each day. The following directions are for the expectant mother.
· Sit in a comfortable position. (A warm bath or warm compresses on the perineum for 10 minutes before massage may help with relaxation.) · Put a water soluble lubricant (KY Jelly, olive oil, vegetable oil, Vit. E oil) on thumbs and perineum. · Place thumb just inside of the vagina. · Press downward towards the rectum and to the sides at the same time until a very slight burning, stinging, or tingling sensation is felt · Hold the pressure for about 1 minute. And chronic genital ulcers seen in tuberculosis and cancer. · Keep pressing down with the thumb and slowly and gently massage back and forth over the sides of the vagina in a ‘U’ movement for 3 minutes.
Figure 1: (a) Local necrotic lesions on the labia majora can be observed; the extensive oedema and erythema of the vulva, the black necrotic eschars, covering the ulcers and the purulent exudate. Caution: Avoid pressure on the urethra (at the top of the vaginal opening), massage gently as vigorous massage could cause bruising or swelling, and do not massage if there is active vaginal infection or herpes lesions. Antenatal perineal massage and subsequent perineal outcomes: a randomized controlled trial. Shipman MK. Boniface DR. Tefft ME. McCloghry F.
Department of Obstetrics and Gynaecology, Watford General Hospital, Hertfordshire, UK. British Journal of Obstetrics & Gynaecology. 104(7):787-91, 1997 July. Refer to the abstract.