Birth preparationPregnancy

The last few months of pregnancy can be particularly exciting, as you count down the time until you can hold your baby in your arms for the first time. However, as the day and the reality of birth draw closer, it’s common to have worries or concerns. Sustaining a perineal tear during birth is one of the things we are most commonly asked about at The Birth Collective. It’s extremely common, with 90% of women experiencing some degree of trauma, whether it’s a graze or a more significant tear.

If you knew there was something that you could do to reduce that risk, would you try? A perineal massage is one of them and can be performed both with and without a partner, with the aim to stretch the perineal tissues ready for birth. 

Don’t worry, this isn’t scary, and we have put together a short guide on how to do a perineal massage with or without a partner, which is easy enough to do in the comfort of your own home.

What as a perineal massage?

Your perineum is the area of tissue between the opening of the vagina and the anus. It attaches to the muscles that support your bowels, reproductive organs, and bladder.A perineal massage will be performed between 4-6 weeks before childbirth and usually on 4-6 different occasions. It is the act of manipulating and stretching the perineal tissue by using one or two fingers. By performing this massage, you can prepare the tissues to stretch over the baby’s body and head during vaginal delivery.

What are the benefits of a perineal massage?

Some benefits of a perineal massage include: 
  • Lowers The Risk Of Tearing – perineal massage during pregnancy has been shown to reduce the likelihood of tears that require suturing or the need for an episiotomy by around 9%.
  • Prepares The Tissues – by massaging your perineum, blood flow increases, helping the tissues and skin stretch more with ease.
  • Helps With Scar Tissue – if you have had a previous injury or have rigid perineum, you might find that a perineal massage will help soften the scar tissue.
  • Helps reduce pain – It may be helpful for overactive pelvic floor muscles, pain with sex, and helping ongoing perineal pain following a previous delivery or injury.

Perineal Massage Preparation

What will you need, and how do you prepare to do a perineal massage? Whether it is you or your partner performing the massage, you will need the following:
  • Short nails
  • Clean hands
  • Uninterrupted time and privacy at home
  • Unscented oils, such as coconut oil, vitamin E oil, or grapeseed oil
  • Pillows for comfort
  • A mirror, if you are going to do the massage yourself.
Before you begin, whoever will do the perineal massage will need to thoroughly wash their hands and ensure that all fingernails are short. Find somewhere where you can relax and where you won’t be interrupted so that you can sit with your legs open wide and your knees bent. Try and find a comfortable position for you.You could try sitting on the toilet, reclining in the bath with one leg up on the side, standing in the shower with one leg up on a stool, or propping yourself up with pillows on the sofa or bed.The next step is to lubricate your perineum. Apply oil on the lower part of your vaginal opening and on your perineum itself, as this will help make the massage more comfortable.

How to do a perineal massage:

  • Start by taking some deep breaths if you feel a little tense, as this should help you relax.
  • You will need to put both thumbs about 2.5cm to 4cm just inside the back wall of your vagina. If you are doing this yourself, you might find it easier to use a mirror the first few times. You will then need to press down towards your anus and to the sides, which will create a bit of a stretching and burning feeling – this is entirely natural!
  • This stretch should be held for about 1 or 2 minutes. From here, gently massage the lower bit of your vagina nearer the opening for around 2 to 3 minutes while focusing on relaxing your perineum. Use your thumbs, moving outwards and upwards, then back again in a U-shape. Try to practice your slow and deep breathing techniques while doing this.
  • Although a perineal massage shouldn’t hurt, you may feel pressure in the first few weeks of starting it, but this should ease.
  • Please note that if you have any vaginal bleeding, your membranes have ruptured, or you have an active infection including thrush or vaginal herpes, you should avoid a perineal massage and speak to your doctor.

How your partner can help with a perineal massage:

In the later stages of your pregnancy, you will find it difficult to massage your perineum yourself, so you can always ask your partner to help. You may find that you want their help from the start, or you may feel more comfortable doing the perineal massage yourself, and then as you get nearer to the due date, ask your partner to do it.If they help you, they should follow the same method as above, but they should use their index fingers instead of their thumbs to perform the side-to-side and U-shaped downward pressure.

How often should you do the perineal massage?

We would recommend practicing this 2-3 times a week from 35 weeks and building in duration and frequency. Be gentle with the tissue and if there’s any pain or soreness then stop or reduce the frequency.It’s advised that you try to fit it into your weekly routine, especially during or after a shower or a bath. This is an ideal time for the massage because your blood vessels will have already dilated, so the perineum will be softer and therefore more comfortable to massage.Perineal massage is a great technique to use in preparation for your labour and delivery. Although this massage doesn’t always guarantee that you won’t need other procedures, such as stitches or episiotomy, or that you won’t tear, it will certainly reduce the chances of intervention.If you would like more information about how to do a perineal massage, help on how to prepare for labour and delivery, or support throughout your pregnancy, please take a look at our courses or contact us directly.
 Article by: Leah Deutsch
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