Perineal Massage: A Way To Avoid Episotomy

Hari ni kiter nak focus pada perineal massage pulak. Walaupun lambat lagi untuk dipraktikkan, tp since dah come across my mind, jom make a note.

Firstly belajar pasal apa itu episotomy. Episotomy ni adalah guntingan yang terpaksa dilakukan pada kawasan perineal (antara vagina dan rectum) pada keadaan kepala baby dah sampai kat situ. Walaupun hakikatnya macam kejam apasal mesti nak gunting2, tapi sebenarnya episotomy ini bertujuan untuk mengelakkan berlakunya cedera yang serious dekat kawasan vagina. Apabila episotomy dilakukan, maka akan memudahkan laluan baby untuk keluar. Sekiranya episotomy tidak dilakukan, akan berlaku kekoyakan pada vagina yang lagi besar dan menyukarkan proses menjahitnya semula. Secara logiknya, ya. Lubang vagina itu kecil, kepala bayi pulak besar. Walaupun vagina itu bersifat elastik, sekiranya terlalu tegang ia akan mudah koyak.

Cara yang terbaik untuk mengelakkan episotomy adalah dengan melakukan perineal massage. Perineal massage ni berfungsi untuk membiasakan kawasan perineal dengan regangan yang akan berlaku semasa kelahiran nanti. Tatau la nak kata ia menyakitkan atau tidak. Tapi kalau ia mendatangkan kebaikan, haruslah mempraktikkannya.

Ada certain pengalaman kawan jugak, semasa dalam labour room, nurse akan lakukan perineal massage untuk kurangkan kecederaan episotomy. Tapi rasanya kalau dilakukan last minit, pastinya tak selesa kan. So mari mempraktikannya bermula drpd minggu ke 34.

Silalah membaca dibawah:

What is the Perineum?

• The perineum is the area of skin between your vagina and rectum.

What is the perineal massage?

• Perineal massage is the gentle stretching and massaging of the skin between the anus and vagina (perineum) during the last few weeks of pregnancy. This massage has been shown to reduce the incidence of episiotomy and perineal tears during birth.

What are the benefits of the perineal massage?

• Perineum becomes more elastic and as a result reduces the possibility of perineal tearing or an episiotomy.
• Prepares you for the feelings of pressure and stretching when your baby’s head starts to crown. Having an idea of what these sensations are like enables you to relax and as a result this can lead to a quicker birth. Tension will delay your baby’s descent.
• 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. This area is very sensitive during the birth so it is often more helpful for the mother to use perineal massage during this time.

Massage techniques:

• Wash your hands and find a relaxing place to do the massage (bathroom, bedroom, where ever you are comfortable)
• 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, etc.) olive oil, vegetable oil or Vitamin 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 1-2 minutes
• Breathe deeply and slowly and try to consciously relax the muscles.
• 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.
• Relax and repeat once.

This massage technique is performed 10 minutes daily beginning at week 34.

Are there any cautions when performing perineal massage?

• Avoid pressure on the urethra (at the top of the vaginal opening).
• Massage gently! Vigorous massage could cause bruising or swelling
• Do not massage if you have an active vaginal infection or herpes lesions.