How to Prevent Perineal Rupture

The perineum is the muscular floor of the pelvis, which plays an important role in the birth process. During childbirth, the baby's head puts a lot of pressure on the pelvic floor muscles, which are stretched as a result. The elasticity of the muscles determines whether they can withstand the pressure and stretch enough for the baby's head to be born. However, there are many factors that reduce the elasticity of the perineal muscles and contribute to its rupture.

In this article we will look at how to prevent perineal tearing and protect it during childbirth.

Exercises to relax the pelvic floor muscles are included in all sets of exercises for pregnant women and help increase the elasticity of the perineal muscles. However, the main prevention of perineal injuries lies in correct behavior during childbirth, timely recognition of signs of a threat of rupture and, if necessary, dissection.

Help to protect the perineum begins from the moment the head is inserted - the moment when, at the height of the attempt, the lower pole of the head emerges from the genital tract. From this moment, extension of the head begins, during which the pressure on the pelvic floor muscles increases sharply. The task of the person delivering the baby is to prevent premature and rapid extension of the head during pushing.

The greatest tension in the perineal tissue is experienced when the parietal tubercles of the head emerge from the genital slit. The midwife positions her hand in such a way that the palm of the hand supported by the perineum gently presses it against the erupting head. This reduces tension and improves blood circulation in the tissues of the perineum, which reduces the risk of rupture.

When cutting through the head, it is important to follow the instructions of the doctor and midwife. At the moment when the parietal tubercles erupt and the pressure on the perineum is highest, you need to breathe smoothly and deeply and not push.

If after the birth of the head the shoulders are not released during the next push, you should very carefully remove the shoulder girdle and body of the child.

However, despite all precautions, sometimes perineal rupture cannot be avoided. In this case, the perineum is dissected.

How is a perineal incision different from a rupture? The tears have jagged edges, they are deeper and heal much worse. Perineotomy - dissection of the perineum to expand the birth canal - is performed using special instruments and under local anesthesia. Dissection is performed only in cases where there is a threat to the life and health of the child and mother, as well as in case of severe anomalies of the birth canal.

It is important to remember that high-quality preparation for childbirth, correct behavior during childbirth and timely seeking medical help can reduce the risk of perineal rupture. If you have any questions or concerns about the birth process, be sure to discuss them with your doctor or midwife.