Preparing for Birth: What About the Part the Baby Actually Passes Through?

We spend months preparing for a baby.

We prepare the nursery. Take prenatal vitamins. Attend appointments. Learn about breastfeeding. Pack the hospital bag. Choose a stroller, etc.

But how much preparation and conversation is devoted to the part of a woman’s body through which a baby’s head may actually pass?

Vaginal childbirth asks an extraordinary amount of the pelvic floor, vagina and perineum - the area of tissue between the vaginal opening and anus. These tissues stretch considerably during birth, but perineal tearing can occur, and sometimes an episiotomy, a surgical incision of the perineum, may be performed.

Can You Prepare the Perineum for Birth?

There is evidence that preparation may have a role.

Antenatal perineal massage, typically introduced during the final weeks of pregnancy, has been studied as a way of preparing the perineal tissues and helping women become familiar with the stretching sensation associated with childbirth.

Research suggests that antenatal perineal massage may reduce some forms of perineal trauma requiring stitches and the likelihood of episiotomy, particularly among women approaching their first vaginal birth.

It cannot guarantee that tearing won’t occur. Birth simply isn’t that predictable.

What About Dilators and Training Devices?

Pelvic and vaginal training devices are also marketed with the idea of gradually preparing tissues for childbirth. Anyone considering using a vaginal training device during pregnancy should discuss it with their obstetrician, midwife or pelvic-floor physiotherapist.

And Then the Baby Arrives!

Suddenly, attention understandably shifts almost completely to the newborn: feeding, sleeping, diapers, appointments and the enormous adjustment to parenthood.

Meanwhile, Mom may be recovering from swelling, soreness, stitches, tearing or an episiotomy, alongside significant changes to her pelvic floor.

That recovery deserves attention too.

Localized cooling, including the use of cold compresses, is commonly used for postpartum perineal comfort, and research suggests cooling may provide short-term relief from perineal pain and inflammation following childbirth.

Better education about perineal preparation before birth — and pelvic and perineal recovery afterward — doesn’t mean every tear can be prevented or every birth can be predicted. It simply means acknowledging something that seems remarkably obvious:

We prepare extensively for the arrival of the baby. Perhaps we should talk more openly about preparing — and caring for — the body delivering it.

This article is for general educational purposes and is not a substitute for individualized medical advice, diagnosis or treatment.