Perineal massage during labor?

[loveslabor]

I had 2 more meetings with potential clients today. The first was very interested in perineal massage. Anyone care to comment?

[raspberrymoondoula]

i've never been in a position where the doc or nurse would let me, i had once where the cnm did it routinely, and another where the nurse seemed extremely uncomfortable that the woman wanted it so the doc stepped in.

just another note- theres no conclusive evidence that it helps at all, a few small studies (will post if i can find em again) have even suggested it might make things worse. :::

[DL]

I don't do that. I let the midwives do it (the ones I mostly work with do it routinely anyways).

For hospital births, the med. staff would HIGHLY frown upon that. For a homebirth...I'd say it's much more open to what you & mom feel comfortable with doing.

[Bree]

I don't do that either.....if they ask about it I would teach them (verbally) how to do that themselves. I think that it might be wise to offer other suggestions on how to avoid episiotomies (i.e. warm compresses, changing positions, etc) and to make sure that they speak to their caregiver about what they do to avoid episiotomies. I myself leave the perineal massaging to the Mom or the medical staff though.

[Tiffany]

Back in 2002 I think it was mentioned at my DONA training that occasionally there have been times where a doula would hold a warm compress to mom's perineum, but never any talk of a doula doing a perineal massage. Holding a compress is more of a comfort measure and it will help the perineum to relax and stretch--we as doulas like all things to relax!

If nobody was doing anything and I felt there was a need, I might blurt out a warm compress as a suggestion.

[~Tranquility~Doula]

No way. I think that would be considered outside of my scope of practice since you have have to insert your fingers into the vagina to do it.

[fearlessbirth]

I think I would get with a local midwife and see what they tell mothers to do as 'homework'. A friend's midwife had her make up a concoction of, I think, ginger and olive oil for her and her husband to massage on the perineum x amount of days/weeks prior to birth. Not sure whether it was effective or not. While I wouldn't be opposed to doing the massage myself if the mother or midwife requested, I would also say it's definitely out of the doula's scope of practice.

[kelley piasecki]

Noelia.....you are right. Is *is* not allowed through our DONA Code of Ethics/Standards of Practice.

[tlcdoula]

I teach moms how to do it during the last few weeks of their pregnancy, but nope I do not touch anyone's vagina! Like someone else mentioned it is very frowned upon in the hospitals and typically it is the doctor who is in the position to do it and not the doula.