The Bottom Line: The Basics of Perineal Massage

The practice of perineal massage is helpful in preventing tears during second stage. While exerting force to push the baby down the birth canal and over the perineum, the tissues must stretch to accomodate the baby's head, shoulders and body. By applying gentle pressure and stroking during the last two weeks of pregnancy, a woman can prepare her body for this intense time of birth. 

Benefits of perineal massage:

1. Helps the tissue to become supple and stretchy.
2. Gives the woman a chance to become accustomed to relaxing when slight pressure is on the perineum.
3. Enhances the birth by providing a tactile focal point for pushing.

This is a simple exercise, but might be easier accomplished with the help of a partner or spouse.

1. Wash hands and trim nails carefully.
2. Use a mild oil such as coconut oil, sweet almond or olive oil to lubricate the index finger.
3. Gently massage the perineal tissue, holding it between the index finger and thumb. 
4. Use mild pressure, which should feel like stretching.
5. Eventually use two fingers, expanding the tissue as you gently massage. 
6. Do not apply too much pressure. 

During birth, it is sometimes helpful for the midwife to apply mild pressure on the perineum to help a woman focus on where to push. By working the tissue ahead of time, it should be more stretchy and pliable.

Comfort Measures During Labor

Women take childbirth classes for a variety of reasons. Typically, learning how to deal with the discomfort of contractions is at the top of most womens list. Last week I surveyed my friends (and Bradley Students) on facebook, just curious about what were the most common comfort measures used in labor.

Twenty two women responded, here are the results.

Hydrotherapy: (they were to check all that applied)
    72 % used the tub, followed by 52 % who stood in the shower.
    Only 22% used cool compresses, followed by 27% who used warm compresses.

Touch Therapy:
    Counterpressure 87% , 43% for effleurage of light stroking, 31% liked the double hip squeeze and  only            4% used accupressure points.

Support person:
       Interesting statistic: exactly 50% used a doula other than their partner/spouse.

Pain Meds:
       Of the 22 that answered the survey, 68 % used no pain meds. Edpidurals only followed at 22%      and          only 9 % said they needed both the epidural and pain meds in the I.V.

  When asked to write about what was most helpful, most women mentioned a support person, such as a doula, their husband or friend. Breathing, working with their bodies, giving in to the contractions, changing positions and being in the tub were common responses.

I think it is important for women to know before they go into labor that they have these options, that a trained support person can help them, and that they don't have to figure it all out by themselves.

Many thanks to my friends and students (a.k.a. friends acquired through teaching!) for answering the survey! It is my pleasure and privilege to know each one of you.

Bright Blessings to you all!

Who takes the child by the hand takes the mother by the heart. ~ 

                                                       German Proverb

 This is for the dad's out there who wonder how they'll do it all....take care of their children, their marriage, their career....listen to the call of your heart. When you nurture and love your children, you reach the heart of your partner in life. When you love and take care of your partner, you also take care of your children. The family is a circle of love. Hold on with all you've got. 

Benefits of Water Birth

Water Birth is offered in many birthing suites across the country and also experienced in many homebirths, as well. What is the attraction of birthing in water? Why would anyone want to sit in a tub to birth a baby?

Here are some surprising benefits to water birth:

• Less pain. Laboring in a warm tub of water has been called a "natural epidural" by natural chilbirth enthusiasts. The warmth of the water releives back pressure, round ligament pain, and the pressure caused by the baby descending deeper into the pelvis.
• Less weight. Mom feels less weight as the water lifts the heavy uterus and it's contents, allowing her some relief from the heaviness experienced during labor.
• Positioning dynamics. A baby who is not coming in a vertex position, but insists on breech or even posterior can be born with less distress in the water. The weightlessness of the water allows for a gentler birth for babies who are coming breech or posterior, giving them time to maneuver their way through the birth canal.

Standard precautions include preparing the birth tub by sterilizing it first, and then filling with pure water. No chemicals should be added. The temperature must be warm, but not hot. The birth attendants can keep the water free from fecal debris released by the mother with small fish nets. The cord must remain intact while baby is underwater to ensure a constant oxygen supply. As with a natural birth out of water, baby may be brought immediately to the breast for food, warmth and bonding.

Even if a woman doesn't give birth in water, most mom's appreciate laboring in either a shower or tub to help manage the pain and discomfort. Standing in a warm shower or kneeling in a warm tub of water can bring sweet relief to a laboring mom.

3 Tips For Writing a Better Birth Plan

Writing a Birth Plan is a little like composing a wish list. You know what you want, you're just not sure if you are going to get it. Women have been criticized by health care providers as if by creating a birth plan we are trying to control the birth process. Nothing could be farther from the truth. A birth plan is more about respecting a woman's right to birth as naturally as she desires, honoring her personal preferences and wishes. By laboring unhindered by unnecessary medical interventions, a woman increases her chances of birthing her child spontaneously and naturally.

When writing a birth plan it is important to keep three things in mind.

1. Be specific.
2. Be brief.
3. Be positive. 

Specific Requests:

• Direct communication is necessary. 
• Clearly state the things that are most important to you.

Brevity:

• Bullet points communicate your wishes in fewer words.
• Lengthy birth plans can put your healthcare provider on the defensive. 

Positive:

• Phrase your requests with positive words, such as "freedom to move around" instead of "do not make me stay in bed."
• State clearly that your plans are in anticipation of a healthy birth for you and your baby and that you are flexible if the course of your labor takes an unexpected turn.

Your baby's birth~day is one of the most important days of your life. It is a day that will impact you as a woman and as a mother. Take the time to carefully think through how you want to labor and birth your baby and communicate that to your birth team. A wise health care provider will listen to you and enter into discussions on what is realistic. If your birth team is not open to such discussion, it may be time to hire a different one.