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36/40 weeks

Perineal Massage

Perineal massage is a way of helping to prepare the perineum for childbirth, making it more flexible so it can stretch easily during labour. Research shows that massaging your perineum from approximately 35 weeks in pregnancy reduces the chances of damage to this area, during birth (with a tear or bruising). This is particularly beneficial in your first pregnancy.  Perineal massage can also help with your recovery after the birth, particularly if you are having your second or further babies. 
In Short
What is the perineum and pelvic floor?

Your perineum is the area of tissue between your vagina and anus (back passage). It connects with your pelvic floor muscles and helps to support your pelvic organs, such as your bladder and bowels. 

During childbirth, your perineum stretches to make room for your baby. As your baby is being born your perineum can sometimes tear. This can affect the support that your pelvic floor gives you at the back wall of your vagina. This can mean you are more likely to have a prolapse (dropping down) of the uterus. A weak pelvic floor can also lead to bladder and bowel control problems. Damage to your perineum might also lead to discomfort and pain during sexual intercourse. 

“Four to eight in 10 women have a perineal tear and about two-thirds need some stitches after a vaginal birth.”

What is perineal massage?

Perineal massage is a way of helping prepare the perineum to stretch more easily for childbirth. During birth, the perineal tissue needs to relax and open to allow your baby to pass through your vagina.

Massaging the perineum increases the elasticity (stretchiness) of the perineum. It improves the perineum’s blood flow and ability to stretch more easily and less painfully during the birth of your baby. It also might reduce the chance of a tear or need for an episiotomy during labour and reduce perineal pain afterwards. This is particularly the case for women giving birth vaginally for the first time.

It can also be particularly helpful if you have previous scar tissue or a rigid perineum, which can occur in some horse riders or dancers. But all women can benefit from doing perineal massage.

Perineal massage can be done by you or your partner, if you are comfortable with this. You may want to start off doing the massages to begin with, then invite your partner to massage as you get nearer to the time of the birth.

When should I start?

You can start at any time form 35 weeks of your pregnancy.

Step-by-step to perineal massage

1. Be Prepared

  • Sit in a warm bath or have a hot shower before you start. This may help you to relax before the massage and loosen the muscles around your perineum.
  • Wash your hands thoroughly and make sure your or your partner’s fingernails are short to prevent scratching to the skin, or any discomfort to the area.
  • Find somewhere you can relax, uninterrupted and in privacy with your legs open wide and your knees bent.
  • Make sure you have your chosen oil. We suggest using a small amount of unscented, organic oil, for example, olive, sunflower or grape seed oil, to lubricate the area and make the massage more comfortable. You can also use an unscented personal lubricant. Do not use synthetic oils such as baby oil or petroleum jelly.
  • You might find it easier to use a mirror for the first few tries, to help you see what you are doing. Therefore, have a mirror handy if you feel that you will need it.

2. Find a comfortable position

  • Propped up with pillows on a bed or sofa with your knees bent out and supported.
  • Reclining in the bath with one leg at a time up on the side.
  • Standing under a warm shower with one leg on a stool, then changing legs.
  • Sitting on the toilet

3. Lubicate your perineum

  • Put some of the recommended oil on your perineum and the lower part of your vaginal opening. This helps to make the massage more comfortable.

4. Technique

Take some deep breaths to help you relax

  • Put your thumbs just within the back wall of your vagina, resting one or both forefingers on your buttocks.
  • Press down towards your anus (back passage) and to the sides. You should feel a bit of burning, stretching feeling.
  • Hold this for about one to two minutes
  • Then gently massage the lower bit of your vagina for maximum of two/three minutes. Massage using your thumbs upwards and outwards then back again in a U-shaped movement. You are aiming to massage the area inside your vagina, rather than the skin on the outside.
  • Repeat as often as you wish, whenever possible.

Perineal massage shouldn’t be uncomfortable, but you may feel pressure and stretching in the first few weeks of starting, which should ease.

Do not do perineal massage if you have:

  • Vaginal herpes
  • Thrush or any other vaginal infection

Partner Involvement

It can be difficult to massage your perineum yourself in the later stages of pregnancy. You may want to start off doing it yourself and then when unable in later pregnancy, if you feel comfortable asking your partner to do it. Simply follow the same method as before. The only difference is that your partner should use their index fingers rather than thumbs.

If you are concerned about tears, need further information about or support with perineal massage talk to your midwife or consultant. They will be able to discuss any increased risk factors related to your birth, and what they and you can do to try to prevent them.

DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.