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Birth Preparation- Perineal Massage

Research has shown that massaging your perineum from 34 weeks, reduces the chance that you might damage this area during birth (with a tear or bruising). This is particularly beneficial if you are having your first baby.

The perineum is the area of tissue between your vagina and anus. It connects with the muscles of your pelvic floor. Your pelvic floor is a hammock of muscles which support your pelvic organs, such as your bladder and bowels.

Stretching or tearing of the perineum during childbirth can affect the support that your pelvic floor gives you. This can mean that you are more likely to have a prolapse (dropping down) of your uterus. A weak pelvic floor can also affect the control you have over your bladder and bowels. Damage to your perineum might also lead to discomfort and pain during sexual intercourse.

Approximately 85% of women will have some degree of perineal tear during vaginal birth.

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perineum

What is perineal massage?
Perineal massage is a way of preparing your perineum to stretch more easily during childbirth. During birth, the perineal tissue needs to relax and open to allow your baby to pass through your vagina.

Advantages of perineal massage:
-It increases the elasticity (stretchiness) of the perineum. It improves blood flow, and the ability of the perineum to stretch more easily, and less painfully during the birth of your baby.
-Tears are less likely and you are less likely to need an episiotomy. This is a cut that is sometimes performed to speed up the birth of your baby or to try to prevent a more severe tear.
-It helps you focus on the feeling of letting your perineum open up.
-Your perineum is less likely to be painful after the birth of your baby.
-It can be particularly helpful if you have previous scar tissue or a rigid perineum, which can occur is some horse riders or dancers.

When should I start and how do I do it?
You can start at any time from 34 weeks of your pregnancy and it can be done by you or your partner, if you are comfortable with this.

When should I do it?
A good time is during, or after a bath or shower, because blood vessels in the area are dilated. This makes the perineum softer and more comfortable to touch. You are also already more relaxed!

We suggest using a small amount of unscented, organic oil for example, olive, sunflower or grape seed oil, to lubricate the area and make the massage more comfortable. Don’t use synthetic oils such as baby oil or vaseline. Make sure your hands are clean before you start.

Comfortable positions include:
-Propped up with pillows on a bed or sofa with your knees bent out and supported.
-Resting back in the bath with one leg up on the side. Then change legs.
-Standing under a warm shower with one leg up on a stool. Then change legs.
-Sitting on the toilet.

perinealmassage

Technique:
-Get comfortable and relaxed in a place where you feel safe, secure and will not be interrupted.
-You might find it easier to use a mirror the first few times to help you see what you are doing.
-Place one or both thumbs on and just within the back wall of your vagina, resting one of both forefingers on your buttocks.
-Pressing down a little towards your rectum (back passage), gently massage by moving your thumb(s) together in a rhythmic ‘U’ shaped movement. You are aiming to massage the area inside your vagina, rather that the skin on the outside.
-Perineal massage should be comfortable but you will also feel a stretching feeling. This is similar to how your perineum will open up as you give birth to your baby.
-Focus on relaxing your perineum as much as possible during the massage.
-Aim for around 5 minutes at a time, but the massage can last as long as you wish.
-With time and practise, as your perineum becomes more elastic, you will increase your ability to relax and can increase the pressure towards your rectum. Being able to relax through this feeling of increased pressure will help you to relax as you feel the pressure in labour and your baby’s head is about to be born.
-Repeat as often as you wish. For the most benefit, aim for a massage everyday or every other day.

DO NOT do perineal massage if you have vaginal herpes, thrush or any other vaginal infection.

If you feel pain at any point, stop and try again another time. If you continue to find this painful speak with your midwife or Laura at Fit Bumps and Mums who can help you check your technique.

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