As expectant mothers get closer to their due date, it’s common to go over everything we can do to prepare for our new baby. We make checklists and go over them a thousand times, but there’s something you might want to add to your list that you may never have expected: perineal massage!
In addition to preparing the baby’s room and packing for the trip to the hospital and the baby’s arrival home, it’s essential that we prepare our bodies for the big day. Perineal massages help soften the tissues that stretch during vaginal delivery. Paying extra attention to your body in the final weeks of pregnancy can help prevent tearing, bruising, or an episiotomy, making recovery easier.
What Is a Perineal Massage?
A woman’s perineum is the area of tissue between the opening of the vagina and the anus. It is attached to the muscles that support the reproductive organs, bladder, and bowels, which make up the pelvic floor.
A perineal massage involves manipulating and stretching the perineal tissue using one or two fingers. The goal is to prepare or condition the tissues to stretch over your baby’s head and body during vaginal delivery, which helps prevent tears. You can perform a perineal massage at home on your own or with your partner’s help (if you feel comfortable doing so).
Benefits of Perineal Massage
Between 40 and 80 percent of women will experience tearing during vaginal birth. About two-thirds of those tears require stitches. Damage to the perineum can lead to various pelvic floor issues, which may include uterine prolapse, sexual discomfort, or urinary or fecal incontinence.
Some benefits of perineal massage to prepare for childbirth include:
- Prepare the vaginal tissues for delivery.
- Reduces the risk of perineal tears.
- It reduces the need for stitches and episiotomies.
- Helps with scar tissue resulting from injury or a tight perineum.
- Prepare the body for childbirth.
When to Start Perineal Massage
Many experts recommend starting perineal massage around the 34-week mark of your pregnancy. Start by massaging once or twice a week. While recommendations vary from person to person, some sources suggest repeating the massage every day or every other day. We recommend talking to your primary care physician or OB/GYN to see what they recommend is best for your body.
Using Oil for Perineal Massage
A variety of oils can be used for perineal massage. The reason we use oil is to provide lubrication and reduce friction. The choice of which oil to use comes down to personal preference.
Whatever you decide to use, it’s best to avoid synthetic lubricants or oils such as mineral oil, petroleum jelly, and baby oil.
Step-by-Step Guide to Giving a Perineal Massage
1: Wash Your Hands: Every massage session should begin with washing your hands. It’s best to use a mild soap that won’t irritate the skin around the perineum. If you have long fingernails, you may want to trim them to avoid poking or scratching the delicate skin.
2: Get Comfortable: Find a comfortable, private space. Some women prefer to perform a perineal massage while lying on a bed or sofa with their legs open and knees bent. If you choose to sit upright, consider using a pregnancy pillow or pillows to support your upper body.
If sitting up or lying down isn’t comfortable for you, there are other options. You can massage yourself while in the shower with one leg on a stool or the edge of the tub (be sure to alternate legs). Sitting on the toilet is an option some women prefer. It’s all up to you and what feels comfortable for you.
3: Begin the massage: If you’re using a natural oil or lubricant, apply some to your clean hands. Start by placing one or both thumbs 1 to 1½ inches inside your vagina. (You may want to use a mirror the first couple of times to make sure you’re in the right spot.)
With your thumbs in position, press them along the back wall of your vagina toward the anus. Don’t press too hard, but you should apply enough pressure to feel a stretch and a slight burning sensation.
4: Stretching: Hold your thumbs in the stretched position for 1 to 2 minutes. Then continue by moving your thumbs outward and inward slowly, in a U-shaped motion. Keep in mind that we’re targeting the tissues on the inside of our vagina, but we should feel sensations on the outside as well.
Relax - We must relax both our mind and body during our massage. While it may seem uncomfortable at first, many women become more comfortable with the process and sensations as the tissues stretch. Keep an eye on the time; a perineal massage should last no longer than 5 minutes per session.
Partners Helping Hands
It’s perfectly fine to ask your partner to help you with a perineal massage. Sometimes we don’t feel comfortable doing it ourselves, or the positions can be complicated. If that’s the case, guide your partner through the same steps as the self-massage, except they should use their index fingers instead of their thumbs.
Pregnancy and childbirth can be emotionally and physically overwhelming. Every step we take to provide strength and comfort during this time is worth taking. Perineal massages can be highly beneficial for the delivery process and the recovery that follows.
