How to Do a Perineal Massage During Pregnancy

Nearing your due date? You’re probably beyond excited to meet your baby and count their precious little fingers and toes!

But before the snuggles, there’s the tiny matter of labor and delivery. You might wonder what you can do to get ready for the big day, aside from packing a hospital bag or attending a birth class.

If you want to do something to prepare your body, consider adding perineal massage to your to-do list. Massage helps soften the tissues your baby stretches during vaginal delivery.

Giving a little extra attention to this area in the final weeks of your pregnancy may help you avoid bruising, tearing, or episiotomy, making your recovery from birth a bit easier.

Related: Your guide to postpartum recovery

Quick anatomy lesson: Your perineum is the area of tissue between the opening of the vagina and the anus. It attaches to the muscles that support your reproductive organs, bowels, and bladder — the pelvic floor.

Perineal massage is the act of stretching and manipulating the perineal tissue using one or two fingers. Its goal is to prepare these tissues to stretch over your baby’s head and body during vaginal delivery. You can perform this massage at home by yourself or with the help of your partner.

Somewhere between 40 and 80 percentTrusted Source of women will encounter a degree of tearing as part of vaginal birth. Around two-thirdsTrusted Source of tears will require stitches. Damage to the perineum can lead to issues with the pelvic floor, like urinary or fecal incontinence, uterine prolapse, or sexual discomfort.

Some benefits of perineal massage:

  • Prepares the tissues. Massage increases blood flow and may help the tissues and skin stretch with more ease but with less pain during childbirth.
  • Lowers risk of tearing. Around 1 in 15Trusted Source women who regularly do perineal massage don’t need an episiotomy or otherwise experience a tear that requires stitches.
  • Lowers need for stitches. Even if massage doesn’t prevent tearing, one study says it may reduce the need for stitches by as much as 10 percent. This basically means that massaging the perineum may make tearing less severe.
  • Helps those with scar tissue. Women who have had a previous injury or otherwise have a rigid perineum (dancers, horse riders) may find that massage is especially useful.
  • Prepares you for birth. Paying attention to the area that stretches the most during delivery allows you to focus on relaxing and learning the sensations you may encounter. This may help you get in the zone both physically and mentally.

You may even want to ask your healthcare provider about perineal massage during labor itself. In a recent review of studiesTrusted Source, researchers discovered that women who received massage during the second stage of labor (during and between pushing) had a lower risk of third and fourth degree tears.

Related: What to expect during a vaginal delivery

Experts recommend starting massage once or twice a week sometime between weeks 34 and 36 in your pregnancy. Some sources say you may repeat massage every day or every other day. As with many things in pregnancy, recommendations differ and may be individual.

No matter how often you choose to do it, you only need 5 minutes a session to see possible benefits. Consider asking your doctor or midwife if they have specific suggestions for when you should start massage and how often you should do it.

You may use a variety of oils for perineal massage. The main goal with using an oil is lubrication to eliminate friction. Choosing a specific type is up to your personal preference, access, and budget.

Types to try:

  • natural oils, like organic sunflowergrapeseedcoconutalmond, or olive
  • personal lubricants, like K-Y Jelly, are also a good choice because they’re water soluble
  • your body’s own vaginal lubricant, if this makes you more comfortable

Whatever you choose, stay away from using synthetic oils or lubricants, like baby oil, mineral oil, or petroleum jelly.

Related: Labor and delivery: The Lamaze method

Step 1: Wash your hands

Begin each and every massage session by washing your hands. Use a mild soap that won’t irritate the skin around your perineum. While you’re at it, it’s a good idea to clip your fingernails short so they won’t scratch or poke at your delicate skin.

Step 2: Find a comfortable position

Set yourself up in a space that’s both private and comfortable. You may want to perform the massage while lying in your bed or on a sofa with your legs open and your knees bent. Consider using pillows or a dedicated pregnancy pillow to support your upper body if you’d like to sit upright.

Other options include massage while in the bath, while standing with one leg on a stool in the shower (switch legs), or possibly while sitting on the toilet. It’s up to you, but make sure whatever area you choose is clean, private, and that you’re safe from falls.

Step 3: Start the massage

Apply the natural oil or personal lubricant to your clean hands. Begin by placing one or both of your thumbs about 1 to 1 1/2 inches inside your vagina. Consider using a mirror the first few times you try massage to make sure you’re getting the right spots.

Then press your thumbs along the back wall of your vagina, toward your anus. While you don’t want to press too hard, you do want to apply enough pressure to feel a stretching and even slight burning sensation.

Step 4: Stretch

Keep your fingers in this stretched position for 1 to 2 minutes.

Then continue on by moving your thumbs outward and inward in a slow U-shaped motion. Remember that you are mostly targeting the tissues on the inside of the vagina, but that you should feel the sensation on both the inside and outside.

Step 5: Relax

Try to relax as much as possible during the massage. This means relaxing both your body and your mind. You may become more comfortable with the sensations as your tissues stretch over time. Regardless, keep your eye on the time. Your total massage time shouldn’t exceed 5 minutes a session.

Partner tips

Your partner may help you if you prefer not to massage yourself or find the position uncomfortable. Instruct your partner to follow the same directions as personal massage, but have them use index fingers instead of thumbs.

Be sure to communicate with your partner if they should apply more or less pressure depending on the sensations of discomfort or burning you’re feeling.

Note

Speak with your midwife or doctor if you experience pain beyond the slight discomfort of your tissues stretching. As well, you should speak with your healthcare provider before performing massage if you have vaginal herpes, yeast infection, or any other vaginal infections.

Regular perineal massage is a good method to add to your toolbox as you prepare for labor and delivery. While massage doesn’t guarantee you’ll not tear or need other procedures, like episiotomy or stitches, it can help you demystify some of the sensations you might feel as your baby enters the world.

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