RE: [ozmidwifery] Perineal massage
I did it personally and didnt tear, and 3 couples I have worked with prenatally also did it and didnt tear. I always recommend it - from 36 weeks, 1-2 x day, 5x week, for 5minutes each time. I also let them know the others factors that prevent tearing too (position, pushing when body tells you too, hands off etc) hth.. From: "Helen and Graham" [EMAIL PROTECTED]Reply-To: ozmidwifery@acegraphics.com.auTo: "ozmidwifery" ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] Perineal massageDate: Thu, 29 Jun 2006 13:57:01 +1000 Just wondering whether everyone is recommending perineal massage antenatally as a way of reducing the risk of tearing? I have read research to suggest it has been effective so I have just started to tell women about it. I also am careful to say that it may not work but there is no harm in trying. I remember it was bandied around years ago but there wasn't any research to support it's effectiveness back then. What are your thoughts Helen -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe.
RE: [ozmidwifery] Perineal massage
Hi Helen, I believe that there is at least a 9% increase in the chance of a primi having an intact peri if they do 10 minutes of perineal massage daily for four weeks prior to birthing. Unfortunately only half the midwives in the study provided the info to the women attending them for antenatal care for a variety of reasons, including that they did think it was worthwhile themselves. Therefore you could reasonably extend that increase up to an 18% chance of having an intact perineum, over and above the roughly 20% chance of having an intact perineum regardless of perineal massage or any other measure. The multis in the study did not experience any benefit. I am sorry I don't have the reference any more. However, I am recommending perineal massage now, particularly to women who ride horses or do a lot of exercise, as from experience these women often have a thick peri. Interested to hear what others say. Nicole. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Helen and GrahamSent: Thursday, June 29, 2006 1:57 PMTo: ozmidwiferySubject: [ozmidwifery] Perineal massage Just wondering whether everyone is recommending perineal massage antenatally as a way of reducing the risk of tearing? I have read research to suggest it has been effective so I have just started to tell women about it. I also am careful to say that it may not work but there is no harm in trying. I remember it was bandied around years ago but there wasn't any research to support it's effectiveness back then. What are your thoughts Helen
Re: [ozmidwifery] Perineal massage
I've seen a great deal of discussion among birthing women on perineal massage and probably equal numbers who did it have torn and not torn. There are so many other factors at play - position, coached pushing, speed of birth - and one important one is a propensity to tearing. Some women tear, most don't under the best possible circumstances and some seem to always tear no matter what. I have seen it be very helpful to women with massive thickened scars from perineal trauma caused by episiotomy who have subsequently birthed over an intact peri. A JB mama had a baby with a compound arm in the RWH BC here in Melbourne - epis, 4th degree damage, surgery, 12 hours till she met her daughter, 2 years physical and emotional recovery. Second child recently birthed at home, also waving as she came out - intact peri! Obviously management was the key for her! J - Original Message - From: Helen and Graham To: ozmidwifery Sent: Thursday, June 29, 2006 1:57 PM Subject: [ozmidwifery] Perineal massage Just wondering whether everyone is recommending perineal massage antenatally as a way of reducing the risk of tearing? I have read research to suggest it has been effective so I have just started to tell women about it. I also am careful to say that it may not work but there is no harm in trying. I remember it was bandied around years ago but there wasn't any research to support it's effectiveness back then. What are your thoughts Helen
Re: [ozmidwifery] Perineal massage
Hello Helen, I have recommended perineal stretching/massage for a long time (over twenty years). Along with good nutrition (zinc!) for tissue integrity. From my point of view, perineal stretching/massage familiarizes women with their anatomy; helps them to conceptualise what needs to stretch and how it can stretch - helps women to really realise how stunningly amazing the whole area (aswell as all the body!) trulyis and the ability to stretch to accomodate anything from a tampon or finger, to a penis to a baby's head and return to normal - not a tunnel but a potential space. Perineal stretching also gives women feedback about the sensations they are most likely going to experience as their baby descends and stretches the perineum. The feedbackteaches them how they can consciously (with awareness)distend their perineum, welcoming the sensations, letting go of tensionand enable it to stretch gently and elastically as they move to adjust the pressure of the head on the perineal area. It has seemed like a very sensible self management strategy from what I have observed. My observation is that the self awareness gained from perineal stretching/massagecan help put the woman in the driver's seat of her own process and therefore is a good thing. I have just put together a perineal stretching information sheet for the women who come to our service. Suzi(thanks Suzi it's great!) shared with me some information and I have utilized that and the drawings in our information sheet. If anyone would like to utilize it, I'm happy to share it with you. Of course, it also includes discussion with the midwives about breath awareness, conscious letting go of tension, movement in labour/positioning to maximise stretchabilty, nutrition in pregnancy etc. If you want the information, email me at work [EMAIL PROTECTED] Also, Wintergreen's Pink Kit is a great resource for pelvic awareness. warmly, Carolyn - Original Message - From: Helen and Graham To: ozmidwifery Sent: Thursday, June 29, 2006 1:57 PM Subject: [ozmidwifery] Perineal massage Just wondering whether everyone is recommending perineal massage antenatally as a way of reducing the risk of tearing? I have read research to suggest it has been effective so I have just started to tell women about it. I also am careful to say that it may not work but there is no harm in trying. I remember it was bandied around years ago but there wasn't any research to support it's effectiveness back then. What are your thoughts Helen
RE: [ozmidwifery] perineal massage
Nice slow stretching as the head descends. Good nutrition -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Päivi LaukkanenSent: Wednesday, 17 May 2006 7:37 AMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] perineal massage Hi everyone, In my store we sell an organic oil by Weleda for perineal massage. ( almond oil, wheat germ oil, natural essential oils.) Many women seem to think, that if they simply apply this oil, it will prevent tears. I am planning to add some info on perineal massage on our website and also prepare a handout to give with the oil. I would appreciate any good links on this subject and answers to these questions: What do you consider the main factors, when preventing tears and episiotomies? (other than perineal massage) Where can I find research on this subject or effectiveness of perineal massage? Päivi
RE: [ozmidwifery] perineal massage
No fundal pressure, no lithotomy position, no rushing. From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Ken Ward Sent: Wednesday, May 17, 2006 10:30 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] perineal massage Nice slow stretching as the head descends. Good nutrition -Original Message- From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au]On Behalf Of Päivi Laukkanen Sent: Wednesday, 17 May 2006 7:37 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] perineal massage Hi everyone, In my store we sell an organic oil by Weleda for perineal massage. ( almond oil, wheat germ oil, natural essential oils.) Many women seem to think, that if they simply apply this oil, it will prevent tears. I am planning to add some info on perineal massage on our website and also prepare a handout to give with the oil. I would appreciate any good links on this subject and answers to these questions: What do you consider the main factors, when preventing tears and episiotomies? (other than perineal massage) Where can I find research on this subject or effectiveness of perineal massage? Päivi
RE: [ozmidwifery] perineal massage
As she feels the burning sensation on the peri encourage her to stop pushing and pant ha ha ha haor blow to allow the uterus to expel the baby without added her own force to it - usually saying stop pushing isnt enough and can be confusing - so to start panting or blowing yourself will give her the cue to follow. jo From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Ken Ward Sent: Wednesday, 17 May 2006 6:30 PM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] perineal massage Nice slow stretching as the head descends. Good nutrition -Original Message- From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au]On Behalf Of Päivi Laukkanen Sent: Wednesday, 17 May 2006 7:37 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] perineal massage Hi everyone, In my store we sell an organic oil by Weleda for perineal massage. ( almond oil, wheat germ oil, natural essential oils.) Many women seem to think, that if they simply apply this oil, it will prevent tears. I am planning to add some info on perineal massage on our website and also prepare a handout to give with the oil. I would appreciate any good links on this subject and answers to these questions: What do you consider the main factors, when preventing tears and episiotomies? (other than perineal massage) Where can I find research on this subject or effectiveness of perineal massage? Päivi
RE: [ozmidwifery] perineal massage
As for research, I dont know if this is still relevant: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrievedb=PubMedlist_uids=10076134dopt=Abstract Am J Obstet Gynecol. 1999 Mar;180(3 Pt 1):593-600. Related Articles, Links Randomized controlled trial of prevention of perineal trauma by perineal massage during pregnancy. Labrecque M, Eason E, Marcoux S, Lemieux F, Pinault JJ, Feldman P, Laperriere L. Department of Family Medicine, Laval University, Quebec City, Canada. OBJECTIVE: The aim of the study was to evaluate the effectiveness of perineal massage during pregnancy for the prevention of perineal trauma at birth.Study Design: Pregnant women with (n = 493) and without (n = 1034) a previous vaginal birth from 5 hospitals in the province of Quebec, Canada, participated in this single-blind, randomized, controlled trial. All participants received oral and written information on the prevention of perineal trauma. Women in the experimental groups were requested to perform a 10-minute perineal massage daily from the 34th or 35th week of pregnancy until delivery. RESULTS: Among participants without a previous vaginal birth, 24.3% (100/411) from the perineal massage group and 15.1% (63/417) from the control group were delivered vaginally with an intact perineum, for a 9.2% absolute difference (95% confidence interval 3.8%-14.6%). The incidence of delivery with an intact perineum increased with compliance with regular practice of perineal massage (chi2 for trend 13.2, P = 0.0003). Among women with a previous vaginal birth, 34.9% (82/235) and 32.4% (78/241) in the massage and control groups, respectively, were delivered with an intact perineum, for an absolute difference of 2.5% (95% confidence interval -6.0% to 11.0%). There were no differences between the groups in the frequency of sutured vulvar and vaginal tears, women's sense of control, and satisfaction with the delivery experience. CONCLUSION: Perineal massage is an effective approach to increasing the chance of delivery with an intact perineum for women with a first vaginal delivery but not for women with a previous vaginal birth. Publication Types: Clinical Trial Multicenter Study Randomized Controlled Trial PMID: 10076134 [PubMed - indexed for MEDLINE] From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of jo Sent: Wednesday, May 17, 2006 11:48 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] perineal massage As she feels the burning sensation on the peri encourage her to stop pushing and pant ha ha ha haor blow to allow the uterus to expel the baby without added her own force to it - usually saying stop pushing isnt enough and can be confusing - so to start panting or blowing yourself will give her the cue to follow. jo From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Ken Ward Sent: Wednesday, 17 May 2006 6:30 PM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] perineal massage Nice slow stretching as the head descends. Good nutrition -Original Message- From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au]On Behalf Of Päivi Laukkanen Sent: Wednesday, 17 May 2006 7:37 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] perineal massage Hi everyone, In my store we sell an organic oil by Weleda for perineal massage. ( almond oil, wheat germ oil, natural essential oils.) Many women seem to think, that if they simply apply this oil, it will prevent tears. I am planning to add some info on perineal massage on our website and also prepare a handout to give with the oil. I would appreciate any good links on this subject and answers to these questions: What do you consider the main factors, when preventing tears and episiotomies? (other than perineal massage) Where can I find research on this subject or effectiveness of perineal massage? Päivi
RE: [ozmidwifery] perineal massage
Then there are these: http://www.update-software.com/Abstracts/AB005123.htm http://www.pubmedcentral.gov/articlerender.fcgi?artid=1121301 http://www.childbirth.org/articles/massageref.html http://www.intermid.co.uk/cgi-bin/go.pl/library/contents.html?uid=870journal_uid=12 Antenatal perineal massage: Part 1 (64kb) Clare Gomme , Mary Sheridan , Susan Bewley British Journal of Midwifery, Vol. 11, Iss. 12, 04 Dec 2003, pp 707 - 711 Randomized controlled trials have provided evidence that antenatal perineal massage is effective in reducing perineal trauma. The provision of information on antenatal perineal massage was introduced as a new service for women and a series of training sessions were held to teach perineal massage to midwives working in antenatal clinics. This article includes a literature review on perineal massage and an evaluation of the massage training. Midwives views on perineal massage and the training they received were obtained through questionnaires and focus group discussions. The response to perineal massage was varied, with some midwives actively promoting the service while others had no interest in the project and did not give information on antenatal perineal massage to their women. Although just under half of all eligible women received information on perineal massage, an audit of perineal trauma rates found a 6% reduction in perineal trauma since the introduction of the new service. You can try Google and type in: perineal massage trauma. From: Vedrana Valčić Sent: Wednesday, May 17, 2006 3:13 PM To: 'ozmidwifery@acegraphics.com.au' Subject: RE: [ozmidwifery] perineal massage As for research, I dont know if this is still relevant: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrievedb=PubMedlist_uids=10076134dopt=Abstract Am J Obstet Gynecol. 1999 Mar;180(3 Pt 1):593-600. Related Articles, Links Randomized controlled trial of prevention of perineal trauma by perineal massage during pregnancy. Labrecque M, Eason E, Marcoux S, Lemieux F, Pinault JJ, Feldman P, Laperriere L. Department of Family Medicine, Laval University, Quebec City, Canada. OBJECTIVE: The aim of the study was to evaluate the effectiveness of perineal massage during pregnancy for the prevention of perineal trauma at birth.Study Design: Pregnant women with (n = 493) and without (n = 1034) a previous vaginal birth from 5 hospitals in the province of Quebec, Canada, participated in this single-blind, randomized, controlled trial. All participants received oral and written information on the prevention of perineal trauma. Women in the experimental groups were requested to perform a 10-minute perineal massage daily from the 34th or 35th week of pregnancy until delivery. RESULTS: Among participants without a previous vaginal birth, 24.3% (100/411) from the perineal massage group and 15.1% (63/417) from the control group were delivered vaginally with an intact perineum, for a 9.2% absolute difference (95% confidence interval 3.8%-14.6%). The incidence of delivery with an intact perineum increased with compliance with regular practice of perineal massage (chi2 for trend 13.2, P = 0.0003). Among women with a previous vaginal birth, 34.9% (82/235) and 32.4% (78/241) in the massage and control groups, respectively, were delivered with an intact perineum, for an absolute difference of 2.5% (95% confidence interval -6.0% to 11.0%). There were no differences between the groups in the frequency of sutured vulvar and vaginal tears, women's sense of control, and satisfaction with the delivery experience. CONCLUSION: Perineal massage is an effective approach to increasing the chance of delivery with an intact perineum for women with a first vaginal delivery but not for women with a previous vaginal birth. Publication Types: Clinical Trial Multicenter Study Randomized Controlled Trial PMID: 10076134 [PubMed - indexed for MEDLINE] From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of jo Sent: Wednesday, May 17, 2006 11:48 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] perineal massage As she feels the burning sensation on the peri encourage her to stop pushing and pant ha ha ha haor blow to allow the uterus to expel the baby without added her own force to it - usually saying stop pushing isnt enough and can be confusing - so to start panting or blowing yourself will give her the cue to follow. jo From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Ken Ward Sent: Wednesday, 17 May 2006 6:30 PM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] perineal massage Nice slow stretching as the head descends. Good nutrition -Original Message- From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au]On Behalf Of Päivi Laukkanen Sent: Wednesday, 17 May
Re: [ozmidwifery] perineal massage
Hi Paivi, I did an extensive literature review and essay for uni in 2004 i can attach for you to yourdirect addressif you like. Breifly after many years of routine episi we were from the 90's able to assess the effects of Antenatal Peri massage on intact rates.and there have been several studies including a canadian study of 1500births. (see ref below). Forfirst vaginal birthsit nearly doubles your chances of intact peri - plus the more you do it the better it works. But little significant difference for multi vag births. However this study also rated womens sence of satisfaction and feeling of control which was higher for both groups. Women have a better understanding of the birth feelings and anantomy from exploring the sensations antenatally. This is not to be confused with Peri Masage IN LABOUR- which THERE IS NO EVIDENCE TO SUPPORT (Stamp, G., Kruzins, G. Crowther, C. 2001, Perineal massage in labour and prevention of perineal trauma: randomised controlled trial, British Medical Journal,vol. 322, no. 7297, pp. 1277-1280.) let me know if you want the whole Lit review. Suzi Canadian study: Labrecque, M., Eason, E.,Marcoux, S., Lemieux, F., Pinault, J., Feldman, P. Laperriere, L. 1999, Randomized controlled trial of prevention of perineal trauma by perineal massage during pregnancy, American Journal of Obstetrics and Gynaecology, [Online], vol. 180, no.3, pp. 593-600, Available: Ovid/[EMAIL PROTECTED] [11 March 2004]. - Original Message - From: Päivi Laukkanen To: ozmidwifery@acegraphics.com.au Sent: Wednesday, May 17, 2006 7:37 AM Subject: [ozmidwifery] perineal massage Hi everyone, In my store we sell an organic oil by Weleda for perineal massage. ( almond oil, wheat germ oil, natural essential oils.) Many women seem to think, that if they simply apply this oil, it will prevent tears. I am planning to add some info on perineal massage on our website and also prepare a handout to give with the oil. I would appreciate any good links on this subject and answers to these questions: What do you consider the main factors, when preventing tears and episiotomies? (other than perineal massage) Where can I find research on this subject or effectiveness of perineal massage? Päivi
RE: [ozmidwifery] perineal massage
I am assuming by now you have googled Perineal massage and got so much information you are overloaded. parenting.ivillage.com/pregnancy/plabor/0,,midwife_46dl,00.html - 52k is one site. But there are heaps more how to **
RE: [ozmidwifery] perineal massage
Johnson johnson have a brochure on perineal care and this discusses perineal massage but also promotes KY jelly product. Gives youanother option to review I hope this helps. Jenni [EMAIL PROTECTED] 03/07/06 4:54 pm Birth International sells a pack of 6 birth preparation leaflets. Among them is one on perineal massage. The pack is $7.00 I dont know if they are available separately. Check with Andrea Robertsons web site. MM From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of islipsSent: Tuesday, 7 March 2006 1:43 PMTo: ozmidwifery@acegraphics.com.auSubject: [ozmidwifery] perineal massage Looking for an education pamphlet to give to antenatal clients that desciribes what it is and how to do it. would like to know where to purchase from rather than photocopy. thanks zoe * This email, including any attachments sent with it, is confidential and for the sole use of the intended recipient(s). This confidentiality is not waived or lost, if you receive it and you are not the intended recipient(s), or if it is transmitted/ received in error. Any unauthorised use, alteration, disclosure, distribution or review of this email is strictly prohibited. The information contained in this email, including any attachment sent with it, may be subject to a statutory duty of confidentiality if it relates to health service matters. If you are not the intended recipient(s), or if you have received this email in error, you are asked to immediately notify the sender by telephone collect on Australia +61 1800 198 175 or by return email. You should also delete this email, and any copies, from your computer system network and destroy any hard copies produced. If not an intended recipient of this email, you must not copy, distribute or take any action(s) that relies on it; any form of disclosure, modification, distribution and/or publication of this email is also prohibited. Although Queensland Health takes all reasonable steps to ensure this email does not contain malicious software, Queensland Health does not accept responsibility for the consequences if any person's computer inadvertently suffers any disruption to services, loss of information, harm or is infected with a virus, other malicious computer programme or code that may occur as a consequence of receiving this email. Unless stated otherwise, this email represents only the views of the sender and not the views of the Queensland Government.
RE: [ozmidwifery] perineal massage
Birth International sells a pack of 6 birth preparation leaflets. Among them is one on perineal massage. The pack is $7.00 I dont know if they are available separately. Check with Andrea Robertsons web site. MM From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of islips Sent: Tuesday, 7 March 2006 1:43 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] perineal massage Looking for an education pamphlet to give to antenatal clients that desciribes what it is and how to do it. would like to know where to purchase from rather than photocopy. thanks zoe
