Perineal massage for childbirth – Why to do it and advice
Perineal massage may be a great way to prepare for your child's birth. The perineum is the area between your vagina and anus, which when delivering your baby can potentially tear, be grazed or need an episiotomy (a cut made by your midwife or doctor). Don’t worry, it is completely normal, up to 9 in 10 first-time women and parents [1] who have vaginal births will encounter some impact to their perineum. So, let's look into the benefits of perineal massage, how it can reduce your chances or the severity of a perineal tear, and how you do it.
What is a perineal massage and why should I do it?
A perineal massage is massaging and gently stretching the perineal tissue to help prepare for childbirth. Making it more flexible, decreasing muscle resistance enabling the perineum to stretch during childbirth resulting in reduced likelihood of episiotomies and tears needing stitches. This in turn also helps to reduce recovery time and recovery pain postpartum due to less impact on the perineum.
The perineum is connected to your pelvic floor muscles and the impact of childbirth can reduce the support to the vaginal walls causing a weak pelvic floor which in turn can cause incontinence or prolapse. Plus, trauma to the perineum can lead to discomfort during sex post baby so it is important to take care of it and include it in your pre-labour preparations.
Does perineal massage prevent tearing?
Research has shown [2] that women who perform perineal massage before labor have a significantly reduced risk of having tears, the severity of their tears, or needing an episiotomy.
Women who have not given birth vaginally before would especially benefit from perineal massage as they are more likely to experience perineal tears, and they see the best results when perineal massage has been performed before labor.
Is perineal massage safe in pregnancy?
Yes, many medical organizations advise perineal massage as long as you don’t have a history of preterm labor, vaginal infections, or other complications.
At first it may feel uncomfortable, and it could sting a little or burn however as you continue this will go away and be more comfortable.
Will perineal massage induce labor?
Perineal massage should not induce labor as you are gently massaging inside of the vaginal walls. If you feel any contractions or severe pain when performing your perineal massage stop and contact your OBGYN.
Is perineal massage recommended?
Yes, many medical professionals and organizations recommend perineal massage for reducing the risk of perineal tears or the need for episiotomy.
When should I start perineal massage and how often should I do it?
It is recommended that you do not start perineal massage until you are at least 35 weeks pregnant. It is best to discuss with your OBGYN before starting, just to be on the safe side. Once you do start aim to do it daily or as often as possible for 2-3 minutes.
What should I use for perineal massage?
For perineal massage, an oil-based product works best to provide the long-lasting glide needed to make it comfortable. YES® OB Oil-Based Lubricant is a natural and organic lubricant that helps protect your intimate health while also providing the glide you need for massage. Made with naturally occurring plant oils instead of silicones, hormones or fragrances we can guarantee the purity of our formulations, which puts you in control of what you are putting in the most intimate part of your body.
How to do perineal massage
Before you start please ensure your hands are clean and preferably have shorter fingernails to ensure you don’t accidentally scratch the skin. Sitting in a warm bath beforehand can be beneficial to help relax and loose the muscles before starting the massage
Step One
Once you are ready, find a comfortable position, preferably on a bed laid back, propped up on some pillows. Lie back with your knees bent and open.
Step two
Take your lubricant onto your forefingers and thumbs and then place your thumbs into your vagina roughly 2.5 to 4cm. TIP using a mirror may help
Step three
With your thumbs inside of your vagina press down towards your anus to feel the stretch. Hold for a minute and ensure you are breathing deeply and trying to stay relaxed.
Step four
Move your thumbs gently from the lower back wall of your vagina in a U shape for a couple of minutes and repeat
Can my partner do my perineal massage?
Yes of course, it may be easier to ask your partner to perform the massage towards the end of your pregnancy. The key is to make sure you are relaxed and comfortable. Make sure they have clean hands, short nails and use a lubricant and perform the steps above, however use index fingers rather than thumbs to curl into the vaginal wall.
Tips for doing perineal massage
With regular massage you will notice more elasticity in the perineal tissue however some tips we recommend are:
- Make sure you apply enough lubricant to make the massage effective and comfortable
- Although at first you may feel a tightness in the muscles you shouldn’t feel pain, be as gentle as you need and work up to a more firm massage as you go on.
- Consistency is important, make perineal massage a part of your bedtime routine to help you fit it into your schedule as this will give you the best results.
Resources
[1] The prevention of perineal trauma during vaginal birth - ScienceDirect
[2] Antenatal perineal massage for reducing perineal trauma - Beckmann, MM - 2013 | Cochrane Library
Perineal massage in labour and prevention of perineal trauma: randomised controlled trial - PMC
