Perineal Massage: How to Do and When to Start

What Is a Perineal Massage?

First things first, let’s understand what the perineum is; it’s the bit of skin between your vagina and your anus. During vaginal delivery, this is the skin that stretches to let out your baby’s head and body. Naturally, it goes through a lot! At least 40% of women experience some tearing of the perineum during vaginal birth, and many experience worse.

A fair number also undergo episiotomy, also known as perineotomy, in which your obstetrician or midwife makes an incision in the perineum during vaginal delivery. This is done when the Oby-Gyn or midwife determines the perineum is not stretching enough to allow passage to the baby.

When to Start a Perineal Massage During Pregnancy?

Expert advice is to start doing perineal massage after week 34 of your pregnancy. Whenever you do it, don’t do it for more than 5 minutes at a time. The perineum is a sensitive area, and you don’t want to overdo any treatment of it. Also consult with your Oby-Gyn or midwife about when you should start perineal massage and how often to do it.

What are the Benefits of Perineal Massage?

Perineal massage will help make your perineum suppler and more ready to take on the strain of vaginal delivery. Benefits include;

• Lower risk of tearing; about 10% of women who regularly do perineal massage before giving birth experience no tearing and don’t require an episiotomy.
• Prepares the tissues of perineum; massage before birth will stimulate blood flow and make the perineum tissue better able to expand with less pain.
• Lowers need for stitches; perineal massage, even when it does prevent tearing, is known to lower the need for stitches. In other words, it makes the tearing less severe.
• Helps mothers with scarred perineum; Mothers who have suffered prior injury to the perineum (for example during horse riding) will benefit especially from perineal massage.
• Prepares mother for birth; stretching the perineum gently during massage will also make the mother accustomed to the sensation, and so better able to push and tolerate pressure during delivery.

Which Oils are best for Perineal Massage?

It’s best to use natural oils like olive, almond, coconut and mustard. Water-based lubricants like K-Y Jelly are also a good choice.

How to do Perineal Massage:

1. You can do the massage yourself or a partner can do it for you, whichever is possible and more comfortable for you
2. Whoever is doing it, the first step is to wash your hands with a mild soap. It’s also best to cut and file your nails
3. Get comfortable; You can either lie in bed or on a sofa, with your upper body supported with a large pillow. You can also be in the bath or shower, with one leg supported on a stool, but don’t do this immersed in water, because that’ll just make it impossible to use the natural oil or water-based lubricant.
4. Apply the oil or lubricant on your fingers. Begin by placing both your thumbs about an inch inside you vagina. If your partner is doing the massage, get them to use their index fingers instead. If doing it yourself, consider using a mirror the first few times.
5. Starting from a 3 o’clock and 9 o’clock position, rotate your thumbs in quarter circles along the back wall of your vagina, until they are both pointing down towards your anus.
6. Keep your thumbs in this position for a minute. Your vagina should feel stretched, inside and outside, even a slight burning sensation is fine, but stop if you feel any pain or definite discomfort.
7. Now bring your thumbs back to their starting positions, slowly. Repeat.
8. If your partner is doing the massage for you, make sure to maintain communication, let them know immediately what is comfortable and what is not.
9. Keep an eye on the time. The total time should not exceed five minutes.
10. Remember to relax your body and mind before and during the massage. If you are stressed and tense for any reason, better to deal with that first by taking a long, warm bath, asking your partner to give you a body massage, or doing whatever most helps you to relax.