The ultimate perineal massage guide

A massage technique that uses your fingers or thumb to slowly and gently stretch the skin and tissues around the vagina and perineum (the area between your vagina and rectum), perineal massage can help you delivery your baby more easily, help prevent tearing and the need for episiotomy and stitches.

 

The perineum is especially important during birth, as stretching or tearing of the area can reduce the support of the posterior wall of the vagina, potentially leading to a prolapse. A weak pelvic floor area can also increase the risk of incontinence post-birth.

Recent research has  confirmed that perineal massage can help prevent tearing during birth. A study by Richard Johanson MD MRCOG at North Staffordshire Maternity Hospital in the UK found that perineal massage in pregnancy can decrease the risk of tearing during a first vaginal delivery. After reviewing different studies, doctors at the University of Michigan also found that perineal massage increases the likelihood your perineum will remain intact during childbirth.

 

Studies also show that perineal massage is most effective in women pregnant with their first baby. If you've had an episiotomy or tearing in a previous delivery, perineal massage may not be as effective.

 

You can start perineal massage in the third trimester, or around week 34 or 35 of pregnancy. Try doing the massage for five to ten minutes daily, twice a day, washing your hands before and afterwards.

 

Perineal massage can be done by you or your partner. If you've never tried it before, take a mirror and look at your perineum first, as this will make it easier when you begin massaging. Also make sure there are no rough edges on your fingernails.

 

Next, find a comfortable position. This might be lying on a sofa or bed, adopting a semi-sitting position or standing with one foot on the edge of the bath or a chair. You can also do perineal massage in the shower.

 

Lubricate your fingers with a special massage oil or KY jelly. You can also use vegetable oils, such as olive oil, but don't use mineral oil or petroleum jelly. Rub enough oil into the perineum so your fingers can move smoothly over the perineum and vaginal wall.

 

If you're doing the massage yourself, try using your thumb (although it might be easier for your partner to use his index fingers). Put the fingers or thumb well inside the vagina, moving them from side to side along the sides of the vagina in a U-shaped movement, to stretch the skin and muscles surrounding the vagina and the perineum.

 

Next, rub the skin of your vagina and perineum between the thumb and forefinger (putting your thumb on the inside, and your finger on the outside, or vice versa). After a few days of doing this, the muscles should relax and the tissue will start to stretch. Always remember to try and relax your muscles as you apply pressure.

 

As you become more comfortable massaging, increase the pressure just enough to make the perineum begin to sting from the stretching. This is the same stinging you will experience when your baby's head is about to crown during childbirth

 

Many women claim a device known as the Epi-No is just as effective as perineal massage – and maybe even easier – as it allows an inflatable balloon to do the stretching and massaging of your perineum rather than your fingers. In the last few weeks of pregnancy, using an Epi-No just involves inserting a balloon-like device inside your vagina and gently inflating it, making it slightly bigger each time you use it, until it’s the size of a newborn’s head. The company estimates that 25,000 babies will be born after using an Epi-No in Australia by January 2012. Order online.