Jan. 20, 2000 (Minneapolis) -- If you're pregnant and would like to experience less pain during childbirth, raise your hand. OK, that's just about everyone. But if the pain of delivery isn't enough, 85% of you will also suffer some form of internal trauma -- most requiring suturing of the delicate tissue around the vagina. The good news is that there is a way to help prevent some of these procedures and pains of childbirth.
Several recent studies have concluded that conditioning the tissues around the vaginal opening with massage prepares the birth canal to perform. And the better a woman prepares her internal tissues for the stretching of birth, the less they will tear, and the better they will heal.
A massage technique performed for 10 minutes daily beginning at week 35 has shown promise in studies of thousands of women. The technique, which involves gentle stretching of the internal tissues using oil lubrication, can significantly decrease the rate of injury and trauma from delivery. In some cases, it may also eliminate the need for episiotomy -- an incision near the vagina to allow ease of delivery. Women should "discuss the massage technique with their clinician, especially in first pregnancies" where the technique has shown to be of most benefit, according to Richard Johanson, MD, of the North Staffordshire Maternity Hospital in England.
The massage method has been well received by pregnant women who have used it. "About 80% of women studied said they would repeat massage in any subsequent pregnancy and nearly 90% said that they would recommend it to another pregnant woman," Johanson says.
Research data has also shown that restricting the use of episiotomy not only reduces the risk of excessive blood loss, but also the risk of future problems including pain, urinary incontinence, and infection.
"Research supports the assumption that [internal] massage and not doing an episiotomy provides a more comfortable recovery with no change in damage to perineal tissues [tissues between the vagina and the rectum]," Pat Sonnenstuhl, ARNP, tells WebMD. Sonnenstuhl is a nurse practitioner and certified nurse midwife in private practice in Olympia, Wash.
"Sometimes women experience a small tear if an episiotomy is not done, which is easily stitched and heals quickly. However, no tears and no episiotomy is even better, and can happen if the [health care] provider supports the perineum at birth," Sonnenstuhl says. "This is beneficial to the woman [and results in] a smoother recovery from her baby's birth."
"Internal trauma affects women's physical, psychological, and social well-being in the immediate post-natal period, as well as in the longer term," Johanson writes. While he believes "the clinician's own preferences in practice may substantially influence the rate and severity of [internal] trauma," Sonnenstuhl says, "recovering from an episiotomy is always uncomfortable."
"Current evidence supports the use of [internal] massage in women completing their first pregnancy and also [limiting] the use of episiotomy in both [first births as well as second and third]," Johanson writes. He says that the massage technique is "promising" and generally "not controversial."
Sonnenstuhl suggests that women discuss the value of perineal massage with their doctor or midwife.
- For pregnant women, a massage technique can significantly decrease the rate of trauma and injury to internal tissue and reduce the need for an episiotomy.
- The massage technique should be performed daily, beginning at week 35, and involves 10 minutes of gentle stretching of the internal tissue using oil lubrication.
- Most of the pregnant women who tried the technique, according to a recent study, would repeat it in subsequent pregnancies and would recommend it for other women.