What is Perineal massage?: What you need to know before giving it a go
It's natural to be concerned about vaginal tearing during delivery, but perineal massage can help reduce the likelihood by gently stretching the area. Continue reading to learn more.
If your due date is approaching, you're probably eager to meet your child, count their toes, and name them. However, there is a small matter of labour and delivery to attend to before the newborn cuddles.
Many of us attend birthing classes, pack a baby bag, and read our hospital notes to prepare for the big day, but you can also go one step further and help prepare your body with perineal massage.
Continue reading to learn more about the benefits of perineal massage if this is your first time giving birth.
What is perineal massage?
You've probably heard of the perineum, and once you're pregnant, everyone wants to tell you all about it. For those who are unfamiliar, the perineum is the area of tissue between your vagina and your anus, and it is connected to all the muscles that support your reproductive organs, bowels, and bladder — the pelvic floor.
The act of gently stretching and massaging this area to soften and relax the tissues, increase flexibility, and reduce the risk of tearing during childbirth is known as perineal massage. It can also assist you in becoming accustomed to sensations in and around the area, preparing your body for what is to come. You can perform a perineal massage on your own or with the assistance of another person, such as your partner.
When you give birth vaginally, all of the muscles in your pelvic floor contract and stretch together, allowing your baby to pass through the birth canal. Your muscles stretch far enough to push your baby's shoulders and body through as their head crowns (comes through your vaginal opening). So the ultimate goal of perineal massage is to reduce pain and your chances of tearing during this stage of your baby's birth.
According to a large study conducted by Oxford University, roughly 90% of women will experience some tearing during their first vaginal delivery. While this figure may seem a little daunting, it may help to know that the majority of cases are superficial (affecting only perineal skin and the outer layer of your vagina) and should heal on their own.
Medical professionals classify vaginal and perineal tears based on their severity:
- First-degree tears, which affect the skin on the surface of your perineum, are the most common (closest to the vaginal opening). They usually heal on their own within a few weeks of childbirth, but they may require stitches in some cases.
- Second-degree tears may necessitate stitches because they extend deeper than the surface skin of your vagina into the perineal muscles but not into the anal muscles
- Third-degree tears affect the perineum as well as the muscles surrounding the anus and necessitate stitches.
- Fourth-degree tears are the most severe but occur in less than 1% of cases. They have an effect on your perineum, anus, and rectum, resulting in a longer recovery time.
Does perineal massage really help?
Yes, in a nutshell. According to a study conducted by Fort Belvoir Community Hospital in the United States, women who practiced perineal massage prior to delivery reported less vaginal pain in the weeks following delivery. However, there is one caveat: Perineal massage is only beneficial if you are not giving birth vaginally for the first time.
According to a study published in the Obstetrics and Gynaecology Green Journal, regular perineal massage (beginning at 34 weeks of pregnancy) may reduce the need for an episiotomy for first-time vaginal deliveries. An episiotomy is a rare procedure performed during childbirth that involves surgically cutting the perineum if it does not stretch sufficiently for your baby's head to pass through.
When is the best time to start perineal massage?
There is no hard and fast rule, but experts generally recommend beginning perineal massage around 34–35 weeks pregnant and continuing it until your due date.
Perineal massage is sometimes performed during prenatal check-ups and even during labour and delivery to help prevent tearing.
How to do perineal massage — tips and techniques
Perineal massage can be performed alone or with the assistance of a partner. After consulting with your healthcare provider to determine the appropriate frequency of perineal massage for your pregnancy, try the following steps:
- Before performing a perineal massage, thoroughly wash your hands.
- Spread your legs apart with your knees bent and find your perineum with your fingers from a comfortable seated position. If you're performing the massage on your own, use a mirror to improve visibility.
- Apply a small amount of natural lubricants to your fingertips or thumb, such as coconut oil or olive oil, and insert it 2 inches (5 centimetres) into your vagina.
- Gently press the right side of your vaginal wall to the right and hold for a few breaths.
- Sweep slowly and press downward, keeping pressure on your rectum. Then sweep to the left and press. Trace and retrace this "U" shape in each direction several times.
- As you get more used to it, you can press downwards while stretching the vaginal walls apart. (This will necessitate the use of two hands!) Hold the position for 2 to 3 minutes.
Remember to begin gently and gradually increase pressure over time. To keep your muscles relaxed, breathe deeply and slowly throughout the perineal massage. Apply enough pressure to cause a slight burning, stinging, or tingling sensation, but never severe pain.
If you have placenta previa or vaginal bleeding in your second or third trimester, perineal massage is not advised. Perineal massage should be avoided if you have herpes or other vaginal infections because it can spread them.
Perineal massage: The takeaway
Perineal massage is a simple and effective way to prepare your body for vaginal delivery and may lower your chances of tearing. While it cannot guarantee that you will not require stitches, it can help you become accustomed to and accept some of the sensations you may experience when welcoming your baby into the world.
Before beginning any pregnancy-related treatment, consult with your doctor to see if perineal massage is right for you.