Midwife Matters

Pregnancy preparations, women's health, and care options

Perineal Massage…A Great Idea!!

on March 22, 2013

One of the biggest fears for women about to give birth is the possibility of experiencing an episiotomy or a tear during their delivery. Statistics show that 40% to 85% of women experience a tear during birth. This tear typically occurs in the perineum, which is the area between your vaginal opening and your rectum. This is the area most likely to require an episiotomy or cut, during labor. Having stitches after childbirth can sometimes lead to pain and discomfort, which most women would prefer to avoid. One method shown to improve outcomes is called Perineal Massage.

Multiple studies have been completed and evidence has shown that perineal massage reduces the likelihood of perineal trauma (mainly episiotomies and significant tears). In addition, women report less perineal pain or discomfort during their recovery. By beginning perineal massage and stretching about one month before delivery, you enable the perineal tissue to expand more easily during birth. In one review, those performing perineal massage for as little as once or twice per week from 35 weeks to delivery were less likely to experience perineal trauma and pain. These results were especially evident for women who had not given birth vaginally before.

So what exactly is perineal massage?

This type of massage involves using two fingers to stretch the perineal tissues. It can be performed by you or your significant other. Ideally, this should be done once or twice daily for 10 minutes, beginning 4-6 weeks before the birth of your baby.

  • Your hands should be clean, and nails trimmed, and a lubricant such as vitamin E oil or water soluble jelly should be used.
  • Lying comfortably back with your knees bent and legs apart, you should practice relaxing the muscles in your perineum. Place your thumb or your partners finger, about 1 to 1.5 inches inside your vagina. Press downward toward your anus and to the sides until you feel a slight burning, stretching or stinging sensation.
  • Now, hold that position for 1 to 2 minutes.  After that time you can gently and slowly begin massaging the perineum while pulling the tissue forward (similar to what the baby’s head will do during delivery).
  • Use this time to practice slow, deep breathing. This should continue for about 10 minutes each day, or as much as possible. After 1 to 2 weeks, you should notice an increase in the perineal ability to stretch with less burning.

Another good idea is to practice Kegel exercises. This helps tighten your pelvic floor muscles, keeping them strong. Do a Kegel while you are performing the perineal massage. You can feel how tense and tight this muscle can become. Consciously release them while you are doing the massage. Practicing Kegel exercises helps improve muscle tone and strength.

Good communication, and gentle understanding is required if a partner is helping perform the massage. However, knowing that you are doing something that may improve your outcome, is free, doesn’t hurt, and is easy to do, makes this a great way to prepare for your delivery.  If you have any questions or concerns, please feel free to contact your midwife.  They will be glad to discuss your concerns and provide further tips in preparing for your delivery.  Best of luck!!


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