You’ve made it to the final month of your pregnancy! You’re only weeks from meeting your new bundle of joy and savoring all the cuddles. But before you can get to the overwhelming happiness upon meeting your sweet baby, several to-dos can help prepare you for delivery. While you may have completed your birth preparation checklist, you may have overlooked adding perineal massage to your action plan.
A perineal massage concentrates on the tissue being stretched to make space for a baby during vaginal birth. It may reduce the risk of tearing or needing an episiotomy, especially for first-time moms. Most moms will tear to some degree during delivery, with most tears occurring in the perineum1. By dedicating a few minutes out of your day to help soften this delicate area during the last weeks of your third trimester, you may help your body’s postpartum recovery.
If you’re feeling inspired to try it out or maybe even a little apprehensive, we’ve broken out a step-by-step guide on understanding the perineum and how to accomplish a perineal massage easily.
What is the perineum?
The perineum is the tissue located between the opening of the vagina and the anus. It connects to the muscles in the pelvic floor. During vaginal childbirth, the perineum stretches to accommodate the baby’s head while crowning. If the perineum stretches more easily, the baby’s head may also come out more easily.
The perineum doesn’t stop there, though. It’s also responsible for stabilizing the pelvic floor, which supports the pelvic organs, such as the bladder, bowels, and reproductive organs. If the perineum tears, it can lead to a weakened pelvic floor and unfortunate symptoms like loss of normal bladder and bowel control.
What is a perineal massage?
A perineal massage is the manual stretching (with one to two fingers) of your perineum to improve its elasticity and soften the muscle. It’s recommended that expecting mothers begin massaging their perineum around 34 weeks and into their pregnancy in preparation for a vaginal birth for five to 10 minutes at least a few times a week.
According to one study, one in 15 women who perform perineal massages regularly does not need an episiotomy or a tear that requires stitches.2 There’s no guarantee that the massage will stop tears from occurring. But it can minimize perineal trauma, reduce bruising, and mentally prepare you for any pain you may feel from your perineal stretching during childbirth.
How to Do Perineal Massage
Moms-to-be can do this alone.3 But if you’re feeling apprehensive, don’t hesitate to recruit the assistance of your partner. Make sure to feel as comfortable as possible, breathe, and relax. Massage your perineum from five to 10 minutes a few days a week (think: Monday, Wednesday, Friday schedule).
Step 1: Wash your hands.
This step should go without saying. But remember to wash your hands using a mild soap to avoid irritation around the perineum. If you’re prone to sensitivity, avoid soaps with fragrance.
Pro tip: Clip your fingernails to avoid scratching a tender area.
Step 2: Find that perfect, comfy spot.
Recruit your prized pregnancy pillow to prop yourself up on a bed or sofa to easily and comfortably reach your perineum. You can also try lying down, keeping your legs open and your knees bent.
If these positions aren’t working, try another private area in your home, such as the bathroom. Sit on the toilet with your legs opened or propping one leg up on the bathtub. If you opt for the latter, bring your partner in for backup and ensure you’re balanced and safe.
Step 3: Oil your hands.
The list of oils out on the market can be overwhelming. But a good rule of thumb is to stick to natural, organic oils you’d typically find in your kitchen cabinets, like olive, vegetable, coconut, grapeseed, sunflower, or even vitamin E oil. Other alternatives include water-based lubricants, such as K-Y Jelly.
Avoid using scented synthetic oils, including baby oil, mineral oil, or petroleum jelly.
Step 4: Start massaging.
Start by placing one or both of your thumbs (or pointer fingers if this is more suitable for you) on the back wall of your vagina. Press down towards your anus and the sides of the vagina, and stretch the skin with your thumbs for one to two minutes.
It’s common to feel a slight burning or stinging sensation from the position, but it’s important to hold the stretch. If the burning becomes unbearable, stop to prevent further pain.
Next, move your thumbs in a U-shaped movement towards the anus to slowly stretch the lower half of the vagina. Continue the massage for another two to three minutes.
Pro tip: The massage should concentrate on the area inside your vagina rather than the skin on the outside. However, you will likely feel burning on the inside and outside during the massage.
Your partner can follow the same steps as above but should use their index fingers during the massage instead of the thumbs. Don’t be afraid to let your partner know if you feel too much pain during the practice. Remember to take a break when needed.
When to not do perineal massage:
Avoid conducting a perineal massage if you have vaginal herpes, a yeast infection, or another vaginal infection. As a whole, it’s always a safe move to consult your obstetrician or midwife before starting the practice.
If you experience pain beyond the slight discomfort during the massage, stop immediately and contact your doctor.
References:
1. https://www.mayoclinic.org/sls-20077129/
2. https://journals.lww.com/ebp/Abstract/2014/01000/
3. https://americanpregnancy.org/-24842/
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