Perineal aching

■ 3rd trimester

During the last month of pregnancy, after the baby has dropped into the pelvic cavity, you may feel a sensation of increased pressure or aching in the perineal area — the area between the vulva and the anus. This dropping, referred to as lightening, indicates that the presenting part of the baby, usually the head, is engaged in the upper portion of the pelvis. If this is your first pregnancy, lightening may happen several weeks before labor. If you've had a child before, lightening usually occurs just before labor. (See also Lightening.)

In addition to aching or pressure in the perineal area, you may feel sharp twinges when the fetal head presses on the pelvic floor.

■ Prevention and self-care for perineal aching

Those trusty Kegel exercises can strengthen your perineal muscles and may help with the aching. To do Kegel exercises, squeeze the muscles around your vagina tightly, as if you were stopping the flow of urine, for a few seconds, then relax. Repeat 10 times.

■ When to seek medical help for perineal aching

Your health care provider may examine you in the last weeks of pregnancy to see if the baby's head is engaged. If perineal aching or pressure grows stronger and is accompanied by a feeling of tightening or contractions, you may be in labor.

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