Preparing for Childbirth

MyKORI can be used to help prepare you for childbirth

How to Prepare the Perineum for Childbirth

How to Massage your Perineum

Before you begin:
• Talk to you midwife to check you are not contraindicated to perform perineal massage you can usually begin massage from 34-35 weeks onwards.
• 5-10 minutes of gentle perineal massage can be formed daily by either you or your partner until your baby is born to help reduce the risk of tearing. There are many reasons a woman can tear in childbirth and massaging your perineum is particularly beneficial for first-time mothers.
• When using your thumbs make sure that your nail are short to prevent any scratching the skin or any discomfort to the area.
• You may like to soak in a warm bath before you begin to help you to relax before the massage and soften your perineum.
• Perineal massage is a soft and gentle massage, be mindful and remember to relax. The massage shouldn’t hurt, although it may feel like you are stretching and a little pressure.

Step 1

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Lubricate your perineum, around your sit bones and upper inner thigh with an organic water based lubricant for internal massage. It is important that your Internal lubricants must not contain harsh ingredients please check the labels before using them.
For external massage only use natural oils such as grapeseed, almond and MCT coconut. These massage oils are best used for areas away from you anus and genitalia. Our vaginas have different pH values to our anus, so both need their own specialised lubricants.

Make sure you find a comfortable position; you need to be relaxed during the massage, so it's important you find a comfortable position. The best place to perform this massage is in bed. Prop yourself up with pillows to support your back and bend your knees. Or try lying on your side with one knee and hip bent.

Step 2

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When you are comfortable –
For a couple of minutes massage over your perineum, vulva and vaginal entrance with gentle stroking and circular movements.

Step 3

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You could start with your thumbs: Hold your thumbs in the position shown below for about 1 minute. Press down towards the anus and to the sides of the vagina walls. Hold your thumbs in this position for about 1 minute. You will begin to feel a stretching sensation. Breathe deeply.

Try self-mapping to locate local areas of tension and discomfort.

Gently massage the lower half of your vagina using a U-shaped movement or rolling action across the tissue the edge of the vagina and across the perineal body either with your thumbs or the thumbs of the massage mitts. Perform these movements for a couple of minutes, REST then repeat a couple more times.

Stay relaxed and breathe calmly though the whole massage.

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When using MyKORI™ reach down and place MyKORI™ length ways at the entrance to your vagina, remember to use more water based lubrication or vaginal moisturiser.

Place the flat end of MyKORI™ length ways an inch (2.5cms) into vaginal opening.
Start with gentle stroking and sweeping movements, then slowly apply just a little more pressure. Stroke back to front and rotate from side to side in a sweeping motion over the entrance of the vagina and the perineal body.

Consider the vagina opening as a clock, sweep, and stroke or rotate gently from side to side from 3-5 o’clock and 7 to 9 O’clock.
Slowly and gently, pressing very slightly, move MyKORI™ both up and down, flat then sideways in a U shape, then hold a gentle pressure before moving onto the next section of the perineum and vaginal entrance.

Work gently and be mindful of how you are feeling, start ‘mapping’ where you are tight, or where you experience mild pain, or discomfort. If it’s too tight, STOP for a moment or two, try some relaxed breathing exercises then try gently massaging again.

Step 4

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Enjoy also gently massaging externally over your vulva, labia, buttocks and pubic region.

By repeating this process daily or when possible, over the next few weeks of massage you notice more elasticity in your perineal area.

Perineal massage is an excellent way to relax; it may also be challenging to do on your own, so get your partner to assist. If they are not willing to massage for you, you will find that practice makes perfect!!!

5-10 minutes daily should be plenty to soften, relax, oxygenate and hydrate you perineum.

Finish with breathing and relaxation exercises.

the-perineum
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Urogenital Triangle

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Anal Triangle

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Perineal body

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Perineal Membrane

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Superficial Transverse Perineal
Muscle

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Superficial Transverse Perineal
Muscle

the-perineum
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Urogenital Triangle

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Anal Triangle

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Perineal body

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Perineal Membrane

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Superficial Transverse Perineal
Muscle

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Superficial Transverse Perineal
Muscle

Healthy pelvic floor structures need to soften and relax for many reasons, they enable:
• Our bladders to fill
• Relax to defecate
• Unfold and unfurl for movement
• Uncurl and lengthen for childbirth, walking and squatting

In childbirth the perineum can lengthen up to three times or more its normal resting length to accommodate crowning of the baby’s head and open to allow the passage of the baby through the vagina. Then amazingly within minutes they recoil back, and we are able to stand up and walk around.

The perineum and the birth canal need to have the ability for the tissue to expand and reposition then contract and recoil to accommodate the various stages of childbirth. Massaging the perineum will help it to stretch more and reduce the tension pain during childbirth and reduce the risk of needing an episiotomy. This is especially important for first time mums.

The birthing perineal progression

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New research has emerged indicating that scaring during normal vaginal birth is more common than originally thought, about 90% of women will experience perineal scaring after a normal vaginal birth and obviously the numbers are much higher for those women who need an episiotomy.

Episiotomy is an incision in the perineum avoiding the perineal body which is a major supporting structure of the pelvis; they cut the perineum at an angle into the softer areas of the perineum. Even after a normal uncomplicated vaginal birth there are a high proportion of women that will be left with scar tissue postpartum.

Research is emerging suggesting there is a good possibility that this scar tissue, even with a normal vaginal birth and without other interventions, is a significant factor of prolapsing later on in life.

Over time the scar tissue becomes less flexible, along with other factors that affect the tissue elasticity for example, prolonged sitting, obesity, menopause, hormones, trauma, surgery, further pregnancies and inactivity are all elements that affect function and elasticity to our perineum, pelvic floor, pelvis and hip movements.

Scar tissue will also increase tension within the structures of the pelvic floor and in between the pelvic organs and can cause; dragging, pulling, bulging and a sensation of heaviness within the pelvis.

This scaring is common at the rim of the vagina where it meet the perineum. We can see now how scaring here will can affect other internal pelvic structures, this reduced inter-structural flexibility and increased tension within the tissue will alter tissue loading, reduce tissue hydration and oxygenation, and in turn decrease pelvic floor function and movement. It is the lowest part of our core and I really feel we haven’t been giving this area the attention it really deserve, nor have we focussed enough on how important it is for both men and women to improve our quality of life and our daily activities and even our sporting performance.

reduce the tension within the vagina walls

Our pelvis and the structures within rely on a healthy three dimensional flexibly interaction and optimal position to function. Perineal and vaginal massaging will help reduce the tension within the vagina walls and perineum, this will help to release the pull of the organs, and the tissue will realign and move more freely.

Massaging both externally and internally to release myofascial tension and scar tissue can have immediate and profound results. Having a tool that you can use in between treatments with you physio, or with guidance from your midwife, or to add to your own wellness routines is empowering. Massaging will help increase pelvic flexibility, function and movement and also release tension to other structure around the hips, sacrum and lower back that are all connected. When you think about how many muscles interact with the pelvis it mast so much sense to look after it more.

After childbirth always discus with your doctor before you return to perineal massage, you need to make sure you have healed complete down there. And you also have to work at a pace that suits you, be gentle on yourself; everyone has an individual birthing experience. Anything that you are unsure of must be checked with your midwife, doctor or health visitor first and make sure your perineum has healed first.