Are there modifiable factors that influence perineal trauma? If so what are they? How can caregivers decrease the incidence of perineal trauma? All ideas welcomed
Jun 30, '00
There are things that can be done to help decrease/prevent trauma. One of our CNM's encourages her clients to do perineal massage beginning in about their 32nd wk (either themselves or their SO); it really makes a difference, both physically and mentally! They already know that "ring of fire" feeling, so they don't panic when the baby's about to crown.
Also, while the client is pushing, the nurse/doc can do gentle stretching around the baby's head (just be sure to use a lubricant). Sometimes, the position a client pushes in can make a difference! If she can get into a squatting position of some sort, then that helps increase the pelvic diameter..plus gravity helps!
The main thing is not to be in a rush!! It galls me to no end to see doc's in a big hurry to get home/to the office/etc cutting an epis that isn't needed.
Hope some of this helped!
Jul 11, '00
allowing the fetal head time on the perineum (heart tones allowing),support and massage of the perineum helps. hot compresses can help too. also open glottis, gentle, steady, even pushes can help. when a baby comes rocketing out from maternal panic or us hurring the delivery, you can expect a repair. i also think mental prep for the mother helps too, if she knows what to expect, she may be more likely to accept what her body is telling her and listen to it, when her bottom says "let met stretch for a minute" perhaps she will. hope this helps.
Jan 19, '01
the most important thing is time and patience, perineal massage,allow time for perineum to strech, lubricant ie. olive oil is a gret on. avoiding use of betadine in drys skin and makes it brittle, warm compresses.
but you will find few doctors who are willing to do this.By the way i am a L&D nurses and have delivered babies of others as well as my own, I have never had a tear or laceration yet. hope this helps,mark
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