Not being told that your perineal length (length of the area between your vagina and rectum) is directly related to your risk of serious tears during vaginal delivery
The perineum is the band of connective tissue that runs between the vagina and rectum and forms one of the attachments of the pelvic floor. Damage to the perineum during pregnancy can have devastating consequences, including bladder and bowel incontinence, sexual dysfunction, pelvic pain and prolapse.
Most women will sustain a small tear of the perineum during vaginal delivery. This is normally fairly innocuous and rarely compromises the attachment of the pelvic floor or the strength of the anal sphincter muscles. However, longer perineal tears (grade 3 and 4 tears) that run from the rectum to the vagina can cause significant damage to the pelvic floor and sphincter muscles, compromising function, endurance and strength.
A woman’s risk of sustaining a more serious tear is partly dependent on the length of her perineum. A perineum measuring 2.5cm or under increases the risk of sustaining a more serious tear. Measuring the perineum prior to delivery allows your obstetrician and midwife to accommodate for any length issues and adapt your birthing plan accordingly.
Perineal massage has been shown to reduce the risk of perineal tears and should be completed by all women from 36 weeks gestation onwards. The technique is designed to be uncomfortable and unfortunately most people do not apply the pressure necessary to have a therapeutic effect. The best way of learning the technique is through demonstration by a Pelvic Health Physiotherapist.
Perineal massage should be completed for approximately 5 minutes, 3-5 times a week. Using a natural lubricant such as Yes! Or Sylk can reduce friction on the skin and allow you to apply the necessary pressure more easily.
Ten’s Prenatal MOTs, conducted by our specialist pelvic health Physios, include perineal measuring, perineal massage, a pelvic floor strength and endurance check, postural and biomechanical assessment and birthing position advice. Any issues can be identified and addressed immediately. MOTs are suitable for anyone from 12 weeks gestation onwards. Speak to our reception team for more information or to book in.
If you’d like to speak to one of our specialist Women’s Health Physiotherapists, please complete the following enquiry form and we’ll contact you to arrange a convenient time.
Self-paid consultations can also be booked online.