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Performing the massage
Creating the environment
Creating the right environment is helpful, so that you can easily relax.
- Soft lighting, possibly using candlelight.
- Burning some relaxing aromatherapy oils such as lavender, or a combination of mandarin and geranium. Experiment with some to find out which ones suit you. (It is recommended not to burn Clary Sage or Rosemary, as these may stimulate labour - save these for prelabour).
- A warm bath is a great way to relax both physically and emotionally. The water softens the perineum just as it does the rest of your skin. It is a similar sensation to your toes and fingers becoming wrinkly after being in the bath for a while.
- If you don't have a bath, a warm compress on the perineum can help you relax before beginning.
- A lubricant is needed. Gentle natural oils such as apricot kernel, wheat germ, almond or vitamin E. In fact any cold pressed oil can be used. Some women use water-soluble lubricants.
- Make sure your hands are clean and your nails have been clipped.
Performing the massage
Use lots of pillows so that you are comfortable in a semi-reclining position. It may be easier if you position your bottom at the edge of the bed. Legs should be comfortably apart, feet flat and knees bent. If this position does not feel right for you try standing with one leg on a small stool or edge of the bed. Try different items around the house until you find something that is the right height for you.
- Wash your hands and trim your nails if needed.
- First, gently rub the lubricant into the outside of your perineal area with your fingers until it is completely worked in. This may take a couple of minutes.
- To do the massage, using a thumb (or thumbs) on yourself instead of other fingers is easier. Remove most of the oil from your thumbs, and then place them shallowly (only up to 3cm) into the vaginal opening just above the perineum.
Image 1-28 is a drawing showing the woman doing her own perineal massage.
- Press down wards towards your anus.
- Then gently stretch out towards each side, in a down and out direction. Gently stretch until you feel a slight burning or tingling sensation.
- Hold stretch for approximately 60 seconds. (The length of an average contraction). Then rest for a minute or two. This allows you to recover and to let the blood circulate into the perineum again.
NOTE: Avoid the urethral opening (at the top of the vagina where you pass water) when massaging. DO NOT perform perineal massage if you have herpes or any other infections are present. The massage can spread and possibly inflame the infection or outbreak. If using oil try to keep most of it on the perineum, rather than inside the vagina. Oil in the vagina can upset the normal balance of microorganisms, making you prone to thrush or gardnerella. Water-soluble lubricant inside the vagina is fine.
During the gentle stretch use your 'out' breath to help you relax your pelvic floor and perineum, allowing it to 'give'. Your 'in' breath through the nose should be deep. Your 'out' breath through the mouth should be slow. Imagine taking the breath down, right down to the perineum and then slowly releasing your 'out' breath as you do the down and out motion of the stretch.
Remember it is only a gentle stretch, it should not be painful.
Feel your perineum give, just as your body needs to give during the second stage of labour for the birth of your baby.
Repeat the stretch 3 or 4 times or more, depending on what is comfortable for you. The total process should take about 8 minutes, or the period of time that feels right for you.
The breath is a wonderful tool to use in labour by practicing a relaxed 'in' and 'out' breath while doing the perineal massage. Stretching with the 'out' breath your body gives a bit more. While the slow deep 'in' breath gives more oxygen to both you and your baby. Again you lay down another body memory - the out breath is related to relaxing, letting go and releasing.
Updated November 2007
Last revised: Wednesday, 12 December 2012
This article contains general information only and is not intended to replace advice from a qualified health professional.