The Perineum

The Perineum

Here you can see a woman who is using upright positions to give birth in, her baby is getting ready to be born.

The area you can see between the bottom and the entrance to the vagina is called the Perineum. This skin and muscle are amazingly stretchy. Its important in labour to allow this area time to relax and stretch.

When we give the perineum time to stretch and relax, the blood is able to flow around these delicate but very stretchy muscles and skin. When the blood flow remains to flow around the perineum, it continues to take oxygen and hormones to the area to allow it to relax and move out of the way for baby’s head to pass through.

In the previous lesson,  you have just learned, your baby will gently move and push the muscles out of the way, as it moves down the birth canal. During this phase of birth, the muscles further down by the perineum also need to relax. When they are relaxed your baby can move more easily between these muscles.

As the muscles thin out and stretch, an amazing process is happening. The muscles fibres here are now lengthening and as they do this the skin is growing and stretching too.

The skin here can actually triple in size as it grows and thins out to allow your baby to be born.

Special Circumstances

It’s very common for women to have some grazes around this area as the muscles and skin stretch. These grazes after birth can sting on passing urine, however, they do heal very quickly.

In all cases, hand hygiene is really important especially if you have other children. You should wash your hands, both before and after changing your pads.

Below is a list of the types of trauma that can sometimes occur.

  1. Injury to the skin – this is quite common and as the skin shrinks back to its original size this will heal without needing any further assistance.
  2. Some injury to the skin and a muscle layer of the perineum. This is also called a second-degree tear. These can happen if the skin is not relaxed enough as your baby passes through OR can sometimes be caused by your baby having its hand by its face as its born. This does sometimes happen and there is not much that can be done to change this.It is also worth noting that just because you have had one of these before it doesn’t mean it will happen again. A midwife should be able to give you a local anaesthetic and complete the suturing in the room. You will be able to feel touching like you would at a dentist.
  3. Injury to the skin, the muscle layers and layers up to the anus. These types of tears will be sutured with spinal block anaesthetic in a theatre. This is to make you as comfortable as possible, and so that the Doctor can take time with the repair, to ensure that it’s going to heal well. Not being able to feel anything, makes it less uncomfortable for you.