Benefits:

It stretches the perineum

It avoids lacerations and need for episiotomy

It relieves the burning sensation as the perineum stretches

 

Objectives:

To reduce resistance on the perineal floor

To achieve a thin and fully stretched perineum

To reduce trauma to perineum

To reduce the likelihood of episiotomy 40-50%

 

Materials:

Olive oil in squeeze bottle (or lubrication)

Gloves

Hot water and cloths (or gauze squares)

 

Procedures:

ACTION

RATIONALE

Start when head is just visible.

Do only between contractions.

It does not interfere with her efforts to feel the contraction.

Work on internal muscle bands, the best strokes are either smooth, full range ones following the sweep of the entire band or else direct, deep ball of fingers pressure penetrations on the tightest areas.

Both are good – the first thins out and stretches, the second breaks up and unknots tension.

Half circular strokes in “U” shape on the perineum itself between points “three and nine o’clock”, alternated with finger inside & thumb outside, grasp-and-pull outward thinning strokes.

To prevent tearing and need for episiotomy.

Very hot compress (almost difficult to touch) may be applied to perineum as head descends further.

To ease the burning sensation; increase circulation; relax perineum.

Where burning is experienced, instruct mother to stop pushing, depending of course on fetal condition.

This is usually the point where internal lacerations start.

As the head is crowning, ask the mother to pant.

This gives the perineum extra time to stretch.

With one hand on the perineum, push upward and inward, and with the other hand keep the head flexed by placing fingers over the occiput downward pressure.

This creates more slack in the tissue, and eases baby’s head over the perineum.

Watch perineum carefully – be sure it stays pink and is not pulled too taut. Watch for it turning white with strain, if so, stop patient pushing and repeat compresses.

Signs of imminent laceration.

From Episiotomy and the Second Stage of Labor

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