One of the many mysteries around childbirth is: How will I push something the size of a small watermelon out of my body without breaking into two?

The short answer is, your body can do miraculous things. One way or another, you will deliver that beautiful baby of yours.

But sometimes this comes at a cost. During my first childbirth, I got a second-degree tear. Tearing is fairly common, especially among first-time moms. Less common these days though (thankfully) is episiotomy, a surgical cut between the vagina and anus to aid in delivery.

Is it possible to avoid tearing or episiotomy? Is there a way to prepare your body for that great biiiiig stretch during childbirth?

Yes.

Probably.

Okay, maybe.

Read on for everything you need to know about perineal massage.

What is the perineum?

The perineum is the soft skin between the anus and the vagina. Because of its proximity to where the baby exits the vaginal canal, as well as the pressure put on it while pushing, this delicate area is prone to tearing—especially for women having their first vaginal birth.

But not all tears are the same. Some are tiny, heal quickly, and require no special treatment. While others may end up on the other end of the spectrum, with deep lacerations requiring stitches and weeks of healing and discomfort.

If only there was something we could do to help prep this area for the flexibility and stretching required for baby to enter the world with your perineum intact… Enter, perineal massage.

What is perineal massage?

Perineal massage is exactly what it sounds like: massaging the perineum. Some women do it for themselves, and others will ask their partners to help. Often, it is done throughout pregnancy.

What for? Perineal massage is done to stretch and increase flexibility in the perineum in preparation for birth, in hopes of keeping the area intact—or at least minimizing perineal trauma during delivery.

Perineal massage video

Okay, it’s an animated gif, but same difference. 😀

Perineal massage video illustrated guides.

You’ll find more detailed instructions on how to do perineal massage below.

Benefits of prenatal perineal massage

Though there don’t seem to be any benefits to perineal massage done during the pushing stages of labor (and it may even cause trouble), perineal massage done throughout pregnancy has many potential benefits.

Easing pain during crowning

It’s said that perineal massage can ease the “ring of fire” so often experienced while baby’s head is crowning. The idea is that gently stretching the perineum regularly will allow it to stretch more easily when baby is crowning, causing less pain.

Helping the baby’s head come out easier and/or quicker

Again, if the perineum stretches more easily, baby’s head may come out more easily or quickly. It may also mentally prepare you for the feeling of pressure and stretching, and may help you become more comfortable with it. If you know what to expect, you may be less tense and more able to stretch.

Avoid tearing

A pair of researchers pooled 4 studies on the benefits of perineal massage and found that it reduced the risk of perineal trauma by 10% for first-time moms. It didn’t show any reduction in perineal trauma for experienced moms, but did show a 32% decrease in the risk of ongoing perineal pain at 3 months post-partum.

Avoiding an episiotomy

The same researchers found that perineal massage throughout pregnancy also helped reduced episiotomies by 16% for first-time mothers, though it didn’t reduce the risk of episiotomy for experienced moms.

Is perineal massage worth a try?

Absolutely! Provided that you’re comfortable trying it, that is.

While there does seem to be some benefit to perineal massage, the difference hasn’t proven to be huge. So if you’re not comfortable with it, don’t stress.

If you are comfortable with giving it a try, perineal massage can only help!

How to do prenatal perineal massage

Here are the step-by-step instructions for getting started with perineal massage at home. As always, check with your healthcare provider about whether perineal massage or any vaginal massage is safe for you.

When to start perineal massage, and how often?

It’s best to start the prenatal perineal massage around 34 weeks. Any earlier, and you may just be wasting your time.

As far as how often you should do the perineal massage, the evidence is not clear. In the Beckmann and Garret review mentioned earlier, the data surprisingly suggests that less-often perineum massage (1–2 times a week) resulted in fewer perineal traumas. However, the largest study in their review showed that the more often women did perineum massage (3–4 times per week), the more likely they were to have an intact perineum.

The simple answer would be to do this vaginal massage at least once a week—and up to as often as you like.

What you’ll need to get started

  • Clean hands (yours or your partners) with neatly trimmed nails
  • Safe, non-toxic and non-irritating massage oil like almond oil, vitamin e oil, or coconut oil
  • A clean towel
  • A mirror (optional)

How to do the perineal massage yourself

First, get your body prepared.

  • Take a warm bath or use a warm washcloth compress to soften the area (10 minutes).
  • Lay in a comfortable position on a clean towel. Try propping your back up with pillows. Position mirror if needed. Keep yourself relaxed and calm so that your bottom can be relaxed and calm too.
  • Apply massage oil to the perineum.

Next, follow these three steps.

1. Insert your one or two thumbs about an inch into your vagina (about to your thumb’s knuckle), and put firm but gentle pressure straight down on the perineum. Allow the perineum to stretch for a minute or two. After it stretches for a few minutes, you may be able to get the second thumb in more easily. Slight burning or stretching is OK, but if you experience pain, use more gentle pressure, or stop the massage.

Perineal massage may help you avoid pain and tears to your perineum during childbirth. Here's how to do it, step by step, with video and photo guides.

2. Once the perineum has been stretched for a couple of minutes, gently move your thumb up along the sides of the vagina, stretching it from side to side. Think about it like running your thumb on the inside of a bowl from one side to the other.

Perineal massage may help you avoid pain and tears to your perineum during childbirth. Here's how to do it, step by step, with video and photo guides.

3.If you are using two thumbs, you can run them from the bottom up to each side, like you’re starting with your thumbs at the bottom of the bowl and running them up opposite sides.

Perineal massage may help you avoid pain and tears to your perineum during childbirth. Here's how to do it, step by step, with video and photo guides. Continue for 3–5 minutes, or as long as is comfortable.

Tip: If you’re having trouble reaching but still want to do the massage yourself, you can prop one foot up onto a chair or toilet seat (so that you’re in a lunge position) and perform the massage as described above.

How to have your partner do the perineal massage

  • Make sure you’re asking a trusted person to help you with this. It doesn’t work as well if you are feeling uncomfortable or tense.
  • Follow the directions above, except have your partner use their index fingers instead of thumbs. They will insert their fingers about an inch into your vagina, about to the knuckle.

Perineal massage bottom line

  • There isn’t a ton of research to support prenatal perineal massage just yet
  • But the info we do have shows that it can be moderately beneficial
  • If you’re comfortable with the idea, then go for it. It can only help!

Did you do perineal massage?

Do you think it was helpful? Share with us in the comments!

 

References

  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590696/
  • http://www.ncbi.nlm.nih.gov/pubmed?term=16437520