Muscle Memory & Your Perineum
You may or may not have ever heard the term "muscle memory" before and if you haven't and you're pregnant now is the time to get familiar with it. The dictionary defines muscle memory as "the ability to repeat a specific muscular movement with improved efficiency and accuracy that is acquired through practice and repetition." What this means is when you do something over and over again with your muscles it eventually becomes second nature for them. You essentially don't even have to think about what to do; you just start and your body just does it.
The idea of muscle memory and your perineum is an important one. The perineum is the section of tissue between your vaginal opening and your anus. That is the area that has to soften and stretch when it's time to push the baby out. You want this area to do so as easily as possible to avoid tearing. Now, there is no way to guarantee you won't tear. The best you can do is do what you can to avoid it. This can potentially help reduce the chance of an episiotomy or lessen the degree as to which they have to do it. We may not be able to guarantee an outcome but we sure as hell can try! There are a couple ways to work on preparing the perineum which I'll explain in just a moment. Pick whichever is most comfortable for you and you can always do both.
One technique is called the perineal massage. This is a technique where you essential massage and stretch the vaginal opening pressing down into the perineum. Basically it's like stretching the vaginal opening at the bottom. You can do it yourself with your thumbs or if you're comfortable have your partner help you. You will want some type of vegetable oil like coconut oil to help your fingers glide over the skin more easily. You want to start at the bottom the opening, press down as you slowly take your thumbs and glide them up the sides of the opening and back down. You will do this while applying pressure. Don't put too much pressure too soon as you don't want to hurt yourself. you should gradually work up to more pressure. Typically you would start this about 4-6 weeks prior to delivery but no sooner. If you check out Mama Natural she has a great blog post about it with animated GIF's that I won't even try to recreate! She also has some great additional information that I encourage you to read.
The other technique is very simple. Take a warm compress and hold it up against your perineum. You can use a warm wet cloth or any other form of a warm compress you are comfortable using. The reason this is so effective is it signals you muscles and your mind to relax. That is what you want during delivery. You want to relax. You want your body to relax; especially the perineum and you want your mind to relax. This can be a more effective tool for delivery because this is really the muscle memory we are talking about. You should do this a few times a week about 4-6 weeks leading up to delivery.
Your third option is to combine the two techniques. You can apply the warm compress for a bit and then try the perineal massage. It may be slightly easier to do the massage after the warm compress. Now I have to imagine the perineal massage offers some muscle memory as well in regards to stretching but It's not the most comfortable thing to do. It's also difficult to get into a position where you can reach your lady parts especially when you're only 4 weeks out from your due date. This is usually why you may opt to have your partner help you but that has it's own set of awkwardness you'll have to work through.
At the end of the day you're just trying to get your body to "remember"; cue muscle memory when you're delivery your baby! I would encourage you to put in your birth plan if you want a warm compress or perineal massage or both during pushing. You're going to want to take advantage of all of the tools you've got in your tool belt! Don't worry you can also ask your doula to remember for you and to remind you during labor to ask for these during pushing.