The perineum is a very important part of a woman's body and it plays a special role during childbirth. It is the area of skin and muscle found between the vagina and anus. During childbirth it stretches to allow the baby's head through. As the pregnancy advances, women may worry increasingly about the trauma and pain that might be experienced during birth. They wonder how something as big as a baby's head can really come out of what appears to be a relatively small hole! The good news is there are things you can do to reduce perineal trauma and pain during childbirth.

Perineal trauma is more likely when:

• Having your first baby.
• Having a forceps or vacuum birth.
• Having an episiotomy.
• Pushing the baby out very fast or pushing for several hours.
• Giving birth lying on your back, especially with legs in stirrups.
• The baby's head is in an abnormal position.
• The baby is very big.

Perineal trauma is less likely when:

• Having your second or subsequent baby.
• Giving birth lying on your side, kneeling or in an all-fours position.
• Perineal massage has been done antenatally.
• Your pelvic floor is relaxed.
•  When you follow your own urge to push rather than being instructed to hold your breath and push.

Perfecting the perineum before and during pregnancy

A health life style
Making sure you have a healthy balanced diet is very important, both before and during pregnancy. This will keep your body in good condition and also help you to heal well if you do have a tear during the birth. Vitamins, such as Vitamin E and Zinc, are important for maximising the health of your skin. Regular exercise also helps maintain a healthy body. Not being overweight before you become pregnant, and making sure you don't gain too much weight when you are pregnant, means you are less likely to get gestational diabetes (pregnancy diabetes) and less likely to have a big baby.

Perineal massage
Perineal massage (gentle stretching of the perineum with fingers) is a well-researched method that has been shown to help reduce perineal trauma. It does not guarantee, however, that you will not t

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