Are you in your third trimester? Are you considering options to help your body prepare for labor?
If so, it’s time to consider how to do a perineal massage. While nearly all midwives and doulas will suggest or recommend it, many doctors leave it out of their birth prep recommendations.
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Questions you might be asking:
- What is a perineal massage?
- How can it help me?
- What do I need to do?
- Which part of my body is my perineum?
- Is it something I can do myself?
To help you, we have the down low on everything you need to know about perineal massage so you can make an informed decision on whether or not this is something you would like to try.
What is a perineal massage?
Many first-time moms are concerned about tearing or needing an episiotomy. Perineal massage can help prevent both of those things!
This massage is something that you can perform on yourself or with the aid of your husband or a trusted partner. It may be hard for you to reach down there so it’s much more relaxing to have your partner do it.
Perineal massage is simply massaging the area (with oil) between your vulva and anus (the perineum) to give the skin elasticity.
The more elastic your skin, the more it will stretch. The more it stretches, the less likely you’ll tear or need to be cut. Your body was made to stretch to give birth. Preparing it for stretching and giving it support during labor (like warm compresses) can only make labor and birth easier.
When can you start a perineal massage?
This type of massage can begin at 34 weeks of pregnancy. Relaxin, a hormone, is produced by your body starting around 34 weeks. It increases gradually, allowing your skin to become stretchier and more elastic. It is best to start with 5 minutes of massage a day and build up to about 10 minutes per day.
What are the benefits of a perineal massage?
Many midwives and healthcare professionals recommend perineal massages. It can help by:
- Reducing the need for an episiotomy, which is a cut to the perineum to help with the birth of your baby or to prevent a severe tear
- Reduce the risk of a tear in the perineum that possibly needs stitches
- Prepare the vagina for stretching during the birth of the baby
- Avoiding assisted deliveries with forceps or ventouse
- Reduce the risk of perineal pain post pregnancy
Does a perineal massage help?
According to research conducted by the Cochrane Collaboration if a woman did the perineal massage regularly from 34 weeks it did reduce the likelihood of perineal trauma (mainly episiotomy and ongoing perineal pain). The impact was evident for women who had not given birth vaginally before. The benefits were less clear for women who had given birth vaginally before.
What are the best oils to use for a perineal massage?
You will need to use lubricant of some sort. However, it is important to use the right kind of oils for a perineal massage to avoid any irritation.
The recommended oils to use are:
- Olive oil
- Vitamin E oil
All of these are known to be effective in smoothing out skin and improving its tone and elasticity. These oils can also help to reduce any scarring.
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A pure massage oil that nourishes and helps prepare the skin to be flexible during childbirth.
Do not use:
- Cream products
- Any petroleum-based oil or perfume oil
- Baby oil
All of these products are known to cause irritation within and around the vagina.
A perineal massage does not require any other tools apart from your fingers.
How to do a perineal massage
Only perform a perineal massage with the permission and advice from your midwife or health care professional.
Before starting your massage, it is important to have a clean vulva and bottom. Always wash your hands before you start. It is also a good idea to ensure you have trimmed fingernails to avoid any scratches.
You may feel more comfortable lying down on your bed. It is also a good idea to grab a mirror and familiarize yourself with your vagina beforehand.
- Use any of the recommended oils mentioned above. Ensure none are perfumed to avoid any irritation to the vagina.
- Breath into and through the stretching and any tension or tightness you may feel.
- Place your thumb into the vagina up to the first knuckle and gently stretch down towards your rectum.
- Use your thumb and forefinger to stretch and massage the perineum while rubbing in a U shape. Then, stretch up and around the labia and underneath the clitoris. Continue on the other side of the labia.
- Stretch your skin until you feel a slight pressure.
- Start off with 5 minutes a day and gradually build up to 10 minutes.
If you feel uncomfortable about touching yourself, you may prefer the help of your husband or partner to support you with a perineal massage. Ensure they have clean hands and short nails. Instead of using their thumb, it may be more comfortable for you if they use their forefinger.
You can find an informative youtube video here which shows a great technique on how to perform the perineal massage.
If you experience any stinging or discomfort at all, then stop immediately and discuss this with your healthcare professional.
Do not perform a perineal massage if:
- Your midwife or health care professional has advised you not to try it
- You’re not past 34 weeks of pregnancy
- You have had any preterm labor symptoms
- You have any infections of the vagina, massaging around this area could cause the problem to spread and worsen.
- You have placenta previa (when the placenta partially or fully covers the opening of the cervix preventing a normal vaginal delivery)
Will perineal massage definitely prevent tearing?
Many women will ask their midwife or health care professional if there is anything they can do to help their perineum cope with the pressure of childbirth. A common recommendation is a perineal massage.
However, there is no guarantee that it will stop your vagina from tearing during delivery or prevent an episiotomy. It will lower your chances, but it may not prevent them completely.
Some women have done the perineal massage from 34 weeks and go on to have a natural vaginal birth with no tearing or episiotomy. And some women have done the massage but will still tear or have an episiotomy during labor.
In the end, it comes down to personal preference. Now that you know how to do a perineal massage, you may want to give it a try and see how you feel!