Perineal Protection - A patients guide

Patient information guide

This guide explains the options available to you during labour to help protect your perineum.

What is the perineum?

• The perineum is the area of skin and muscle between the vagina and the anus.
• It stretches during birth to allow the baby’s head to come out.
• This stretching can sometimes cause tears which can be painful after birth.

Warm compress

• A warm cloth placed on your perineum during the pushing stage of labour, just before you give birth, may help lower the chance of tearing.
• It can feel soothing and comfortable.
• If you would like this, bring a flannel so the midwife can make a warm pack for you during labour.

Hands on support during labour

• Your midwife may protect your perineum by supporting the baby’s head with their hand and advise you when to stop pushing and just breathe.
• This is to let the baby’s head deliver very slowly.

Positions in labour

• It is important to try different positions during labour. You should see what feels best for you.
• Upright positions like standing, being on all fours, or using a birthing stool can help your baby move down by using gravity. You may also need to rest at times.
• Lying on your left side is a good resting position. It helps create space in your pelvis for the baby to move down.
• When pushing, good positions include being on all fours, semi-sitting, or lying on your left side with your top leg raised to help open the pelvis.

Episiotomy

• An episiotomy is a cut in the skin between the vagina and anus – the perineum.
• Midwives and doctors will usually try to avoid an episiotomy.
• However, in some situations, it may be needed during childbirth.
• For example, your baby shows signs of distress on the heart rate monitor and must be delivered quickly.
• After the birth, the cut is stitched and usually heals over time.
• Alternatively, you may need an instrumental birth, using forceps or a ventouse (a suction cup), to help prevent a large tear.

Contact our service

Whittington Bladder and Bowel Care Service
Email: whh-tr.bladderandbowel@nhs.net
Webpage: https://www.whittington.nhs.uk/?c=33288

Whittington Pelvic Health Physiotherapy
Email: whh-tr.outpatienttherapy@nhs.net
Webpage: https://www.whittington.nhs.uk/?c=42977

North central London perinatal pelvic health service - Royal Free London
Email: rf-tr.nclpphs@nhs.net
Webpage: https://www.royalfree.nhs.uk/services/maternity-services/maternity-support/north-central-london-perinatal-pelvic-health-service