Perineal Massage During Pregnancy. The What, Why & How!

WHAT IS PERINEAL MASSAGE?

Perineal massage is the gentle stretching and manipulating of your perineal tissue using one or two fingers to help prepare these tissues to stretch over your baby's head and body during vaginal delivery.

You can do this massaging action yourself or with the help of your partner.

HERE’S SOME WAYS THAT PERINEAL MASSAGE DURING PREGNANCY MAY HELP:

Lowers risk of tearing
Reduces need for stitches
Prepares you for birth
May prevent scarring
Reduce risk of postpartum incontinence
Less perineal pain

Trauma to the perineum during birth can be in the form of a spontaneous perineal tear or an episiotomy. The chance of having a perineal tear range from 30-85% and is more common in first time mums.

Statistics show that women over the age of 35 are 4.36% more likely to have perineal trauma than younger women. Other risk factors for perineal trauma include maternal obesity, macrosomia (baby over 4.5kg), baby in a malpresentation (unusual position) or malposition (such as posterior position) and instrumental vaginal births.

TYPES OF PERINEAL TEARS

Perineal massage involves stretching the vaginal tissues towards the end of pregnancy to relax and improve circulation to the tissues, increase elasticity, desensitise women to pain during labour and enable easier pushing during delivery.

Reducing trauma to the perineum and vagina may decrease the episiotomy rate in women having their first baby.

WHY IS IT IMPORTANT TO REDUCE PERINEAL TRAUMA?

Short term impacts of perineal trauma include:

Postpartum pain
Increased pain relief requirements postpartum
Pain on urination
Pain with sexual intercourse

Long term impacts of perineal trauma include:

Pelvic floor dysfunctions such as pelvic organ prolapse, urinary incontinence, flatus incontinence and faecal incontinence
Birth trauma
Increased rates of caesarean births in subsequent births

Reduction in perineal trauma can have significant benefits for a new mums mental and physical health and their ability to bond with their baby.

For perineal massage to be effective in reducing perineal trauma it needs to be commenced from the 34^thweek of pregnancy. Perineal massage is performed either by the woman or her partner for a minimum of 4 minutes 3-4 times a week.

HOW TO PERFORM PERINEAL MASSAGE:

Empty your bladder and wash your hands
Find a relaxing place to sit comfortably, a mirror can help you see what you’re doing
Have a warm bath or use a BodyICE Woman Perineum Strip as a warm compress on the perineum for 10-15 minutes before you begin
Put a generous amount of lubricant like natural oil (olive oil or coconut oil) on your thumbs and perineum
Place your thumbs inside the vagina (approx. 3-5cm in). Gently press downward towards the rectum and sides of the vagina to stretch the opening. You should feel a very light burning sensation.
Place your thumbs together and very slowly and gently sweep the perineum in a ‘U’ shaped motion away from each other at the sides of the vagina
As you perform the massage, try to focus on relaxing your pelvic floor muscles and deeply breathing
Relax and repeat

It is important that you only feel a slight burning or tingling sensation, you do not want to press too hard as it may cause bruising and swelling.

Avoid putting pressure at the top of the vaginal opening. If you have any concerns, always speak to your healthcare provider prior to undertaking perineal massage.

GUEST AUTHOR, LAUREN BRENTON

I’m Lauren and I’m an Endorsed Midwife and a Clinical Midwifery Specialist. This means that I’m a Registered Midwife who is recognised as being able to provide a high level of clinical knowledge, experience and skills in providing complex midwifery care. I have completed a Bachelor of Midwifery and a Master of Midwifery. My favourite area is in the labour ward, this is where you can find me most days. There is no better feeling in the world than being involved in parents meeting their baby for the first time.

Outside of work, I’m a MUM!! I have an amazing husband, Josh and 4 beautiful little kiddies - Mason, Lyla, Coda and Wilder.

One Mama Midwife grew from my passion for helping families be well educated around pregnancy, birth and the postpartum period. Especially when there can be so much confusing information out there, you can know that the information you find here you can trust.