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Fire down below

by Pat Thomas
continued from page 1
  • Most post-natal wards have what are known as ‘valley cushions’ to help relieve the pain resulting from tears and episiotomies. They inflate to just the right level of support to help you sit comfortably. You can’t buy them for yourself yet but you can hire them from the National Childbirth Trust at a charge of £10.50 for five days. For further details call the NCT on 020 8992-8637.
  • Try either a cold or warm sitz bath. This is a shallow bath – the water should only be deep enough to come up to your perineum (3 or 4 inches). While you might think that warm baths are the most soothing on the perineum, one study several years ago in the Journal of Obstetric, Gynaecologic & Neonatal Nursing found that while both cold and warm baths could deliver some degree of relief, cold baths were the quickest and most effective. If you like you can put some witchhazel or a handful of baking soda in the bath to enhance the effect.
  • Herbalists recommend a warm decoction of oak and comfrey barks to which you can add either marigold or lavender flowers. If the damage to your perineum is quite deep and you are concerned about infection, add a tablespoon of slippery elm and golden seal powders to the mix. Brew these ingredients to make a strong ‘tea’, strain off the liquid and add to either a warm or tepid sitz bath. You can also use this mixture in a bidet or, just as effectively, in a large washing up bowl. Use it to soak your perineum 20-30 minutes twice daily (or if you have had sutures only once daily). In the end, prevention may be the best way to limit trauma to this part of your body. Some midwives now recommend that women massage their perineums from 37 weeks of pregnancy. Until recently there have only been small studies and anecdotes to show that this method is effective.

    However, in 1999 a large study in Canada, published in the American Journal of Obstetrics and Gynaecology, found that perineal massage was an effective way of avoiding tears and cuts. In it, one group of women were instructed to massage, or have their partners massage, their perineums every day from 34 or 35 weeks. These women were compared to another group who did not use perineal massage. The result was that significantly more women in the massage group had intact perineums after birth.



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