What is the perineum?
The perineum is the area of skin and muscle between the vagina and anus.
What can happen to the perineum?
The pressure of giving birth on your perineum means it may tear or need an episiotomy (surgical cut) when your baby is born.
"Up to 9 in 10 first-time mothers who have a vaginal birth will have some sort of tear, graze or episiotomy."
An episiotomy is a non-routine surgical cut to the vaginal opening, which is intended to prevent more serious tears.
Up to one in 10 women experience pain for up to 18 months after a serious perineal tear or episiotomy.
Yet there is something you can do that might help – perineal massage. Research has shown that perineal massage reduces the chance of a perineal tear or episiotomy.
Another review showed that pelvic floor exercise and perineal massage reduced perineal trauma, while the EPI-NO perineal dilator (marketed as a childbirth and pelvic floor training device) had no benefit.
What is perineal massage?
Perineal massage is a way of helping to prepare the perineum for childbirth, making it more flexible so it can stretch more easily during labour. Massaging the perineum reduces the chances of a tear or an episiotomy during labour and perineal pain afterwards. This is particularly the case for women giving birth vaginally for the first time.
Perineal massage involves massaging the area between the vagina and anus during late pregnancy. Some women massage their perineum themselves, while others prefer to get their partner to help.
When can I start doing perineal massage?
From when you’re 35 weeks pregnant onwards.
What Oils Can I use?
You can use any organic and pure oils such as coconut oil, However Welda and My Expert Midwife Peri Prep Your Bits 30ml Perineal Massage Oil are recommended products which are Mid-wife developed. The following oils can be purchased online from stores such as Boots,chemists or Amazon.
How does this work?
Wash your hands thoroughly and make sure your or your partner’s (if they’re helping) fingernails are short.
Find somewhere you can relax, uninterrupted and in privacy with your legs open wide and your knees bent.
Make sure you have your chosen oil and your mirror handy if you need it.
2. Find a comfy position for you
You could try:
being propped up with pillows on a bed or sofa so you or your partner can reach your perineum more easily
reclining in the bath with one leg up on the side at a time
standing in a warm shower with one leg up on a stool before you change legs
sitting on the toilet.
3. Lubricate your perineum
Put some oil on your perineum and the lower part of your vaginal opening. This helps to make the massage more comfortable.
4. Relax and start the massage
Taking some deep breaths might help you relax.
Put your thumbs about 2.5cm to 4cm just inside the back wall of your vagina. You might find it easier to use a mirror the first few times.
Press down towards your anus and to the sides. You should feel a bit of a stretching feeling.
Hold this stretch for about one to two minutes.
Then gently massage the lower bit of your vagina for around two to three minutes, focusing on relaxing your perineum. Massage using your thumbs upwards and outwards then back again in a U-shaped movement. You could practice your slow, deep breathing techniques while you do this. Repeat this two to three times.
Some people will focus the massage on any previous scar tissue.
Perineal massage shouldn’t hurt, though you may feel pressure in the first few weeks of starting, which should ease.
5. Partner involvement
It can be difficult to massage your perineum by yourself in the later stages of pregnancy.
You might want to start off doing the perineal massage yourself. Then as you get nearer to the due date, if you feel comfortable doing so you could ask your partner to do it.
Simply follow the same method as before. The only difference is that your partner will use their index fingers rather than thumbs to perform side-to-side and U-shaped downward pressure.
6. Keep up the routine
Repeat daily or when possible.
Fit it into your daily or weekly routine, for example during or after a bath or shower. This is a good time because blood vessels in the area are already dilated, making the perineum softer and more comfortable to massage. You will also be more relaxed.
Visit NCT for further advice or alternately NHS website for further advice!