Perineal massage is a great way to help prepare your body for childbirth. This practice is best done during late pregnancy, after 34 weeks, and while it has many benefits, it’s not often discussed with expectant mums.
What is the Perineum?
The perineum is made up of muscle and tissue, and is the area between the bottom of the vagina and the anal sphincter. It is designed to stretch during childbirth to allow your baby’s head to pass.
Unfortunately many women experience tearing during childbirth, which often requires stitching. There are different degrees of tearing, from minor to more serious third-degree tears that can involve the perineum tearing from the vagina right through to the back passage.
The results of this are both painful and complicated.
Damage to the perineum is often seen as inevitable in childbirth, especially as up to 60% of women have episiotomies.
An episiotomy is a surgical procedure that involves cutting into the muscle tissue around the vagina to allow for the baby’s head to pass more easily, or with the assistance of forceps or vacuum extraction.
It requires stitches and can make urinating and bowel movements difficult after labor, and can lead to pain during sexual intercourse and sex-related complications later on.
Needless to say, protecting the perineum is a priority for many expectant mothers, who would rather focus on bonding with their baby after childbirth than having to deal with perineum-related postpartum complications.
I know that perineal massage is not something every mom-to-be is willing to try, but for those who are interested in practical ways to reduce the risk of tearing or having an episiotomy, I’ve prepared a practical, midwife-approved guide.
Luckily, it’s not as complicated as it sounds, and the results are well worth a try!
What Is It?
Perineal massage is not exactly a massage in the traditional sense of the word. For a start, it is in a very intimate place and is designed to get you mentally used to the sort of discomfort you could expect during the pushing phase of childbirth.
The procedure is not always comfortable and has a very specific focus—increasing the elasticity of the tissue in this area.
Massage of the perineum does take some getting used to and definitely requires practice, but the benefits can be great.
According to the World Health Organization, the median head circumference for girls at birth is 33.9 cm.
Boys come in slightly bigger at 34.5 cm.
What Are the Benefits of Perineal Massage?
Scientific studies have shown that women over 30 who are having their first experience of childbirth are most likely to benefit from regular perineal massage. The main benefits are as follows:
- Softens your perineum
- Increases blood flow
- Less likely to tear during childbirth
- Less likely to need an episiotomy
- Prepares you for the sensation of pressure, which can help prevent tensing during the pushing phase of delivery
- Familiarizes you with the feeling associated with an internal examination
- Reduces the risk of perineal pain during and after childbirth
As well as these practical outcomes, one of the major advantages of perineal massage is increased confidence in your body’s ability to give birth. And being psychologically prepared for childbirth is always an advantage!
How to Do Perineal Massage: Step by Step
You can start practicing perineal massage on a regular basis from the 34th week of pregnancy. Most women like to do it in the evening after a relaxing shower or bath.
First-time mothers can do perineal massage once or twice a week. For women who are giving birth for the second time or beyond, practicing perineal massage three to four times a week is seen to have more benefit.
How to Do It:
Most women prefer to do their own perineal massage but some feel comfortable enough to allow their partner to do it for them. There’s no right or wrong, so only get your partner involved if you are both game.
The trickiest part is getting into the correct position, so experiment until you find what works for you.
- Start by washing your hands and make sure your nails are trimmed
- Make yourself comfortable. You can stand with one foot on a low stool or bench, sit down with the support of pillows, or lie on your side
- Use a mirror if you can as this will help you master the technique more quickl
- Apply a few drops of oil like sweet almond or wheat germ to your thumbs as this will make the massage more comfortable
- Insert one or two thumbs (or fingers if you can’t reach) about 1.5 cm inside your vagina
- Gently push downwards toward the anus and to the sides until you start to feel a burning/tingling/stinging sensation
- Aim to hold this pressure until you no longer feel tingling or stinging and it instead feels numb. This usually takes around two minutes
- Keep pushing down and gently massage the perineum in a U shape to the sides, and back and forth. Continue for two to three minutes
Are There Any Risks to Doing Perineal Massage?
No. Perineal massage doesn’t pose any risks to your unborn baby and before you ask, it’s impossible to overstretch your vagina. It’s a safe practice that can help reduce the risk of perineal trauma.
Are There Any Alternatives?
If the idea of perineal massage doesn’t feel right for you, there are other ways prepare your perineum. The most common are childbirth and pelvic floor trainers such as the EPI-NO, which gradually stretches the perineum and conditions the pelvic floor muscles.
The EPI-NO and other inflatable devices provide similar benefits as perineal massage.
Nothing to Lose
Pregnancy and childbirth are such a huge feat for your body that giving your perineum some time and attention leading up to delivery is surely worth a try.
There’s no obligation to do it, but there’s also nothing to be lost by investing some time in perineal massage.
In my experience as a midwife, I've seen first-hand the physical and psychological benefits of the practice. And if you can come away from the experience having avoided serious tearing or an episiotomy, then it’ll have been time well spent.