How can a perineal massage help first time mums/parents?
What is a perineal massage?
A perineal massage involves gently stretching and massaging the tissues surrounding the perineum, which is the area between the vagina opening and the anus (see the image below from the NHS, which shows the area we’re talking about). It works extra hard in birth due to the extra weight and pressure. Before birth, massaging this area to stretch it and make it more elastic, reducing the chance of tearing.
4 reasons you should do a perineal massage
Decreases likelihood of perineal trauma: a study published in the Cochrane Database of Systematic Reviews indicated that perineal massage could potentially reduce the risk of perineal trauma, particularly among first-time mothers.
Improved flexibility: doing perineal massage regularly can make the tissues around the perineum more flexible and stretchy.
Improved blood circulation: massaging the perineum can bolster blood flow to the area.
Empowerment: practicing perineal massage can give a feeling of empowerment, allowing you to feel more in control of your body and childbirth.
When should you start to practice perineal massage?
Starting perineal massage around the 34th week of pregnancy is usually a good idea. If you start earlier, you might not see much benefit, and if you start too late, your body might not have enough time to adapt.
But it's really important to talk to your healthcare provider before you start, just to make sure it's safe and to address any questions or worries you might have. If you have a known vaginal infection, thrush or genital herpes it’s best to avoid it.
Can my partner help?
Some people feel more comfortable doing the massage by themselves whilst others feel better getting their partner to help them out. If you choose to get aid from a partner, make sure you explain what needs to be done (detailed in the step by step guide below), and also communicate clearly whilst it’s happening to make sure a comfortable amount of pressure is being used. As your pregnancy progresses, it can become difficult to reach down there so having the aid of a partner can be handy if you’re comfortable with it!
Step by step guide on how to do perineal massage
Thoroughly wash your hands with soap and warm water and make sure your nails are short. The Royal College of Obstetricians and Gynaecologists also recommend to sit in a warm bath beforehand to relax and loosen your muscles.
Assume a comfortable, relaxed position, such as sitting with your back supported with comfy pillows, lying down with knees bent, or standing with one foot elevated on a stool. You can position a mirror to see what you’re doing.
Apply a small amount of unscented water-based lubricant or oil to your thumbs and perineum.
Insert your thumbs approximately 2 to 3 centimeters into the vagina, exerting gentle downward pressure towards the anus. We’ve included the below diagram from The Royal College of Obstetricians and Gynaecologists as a guide.
Gently massage the perineal tissues by pressing your thumbs against the sides and stretching outward and downward in a U-shaped motion.
Maintain the stretch for approximately one minute, focusing on deep breathing and relaxation of pelvic floor muscles.
Continue massaging for 2 to 3 minutes, using gentle yet firm pressure, gradually intensifying the stretch as tolerable, this may be uncomfortable but should never be painful, cease the massage if you do feel pain.
Continue this practice daily or when you can. It may take a while before you notice a difference in elasticity, but keep it up!
Not everyone is comfortable with the idea of perineal massage and it can be uncomfortable, especially to begin with. So don’t put pressure on yourself if it’s not for you, or if it takes some time to build up to the times we talk about here. But think of this as part of your toolbox, perineal massage won’t guarantee that you won’t tear, but it is one method you can use to reduce the chances.
