Perineal Massage. Just by saying those two words, I may have already got you offside! Some women are open to this technique and others are not. So here, we’l present the technique and look at the evidence behind it as a preparation for Labour, including less risk of tearing and episiotomy. (Which are the best reasons to consider Perineal Massage) I was advised by a mother of three who never had an episiotomy because of this technique, to consider it and it worked for me.

You want me to do what?!? Perineal Massage is a technique that prepares the tissues around the vagina for the second stage of labour (after Transition), which is “the pushing urge” and crowning. Obviously if this is your first time birthing vaginally including VBAC and first time mothers, it would be something to consider as a positive part of your labour preparations.

Ok let’s get directly to the point and speak matter-of-factly. If this next part is confronting, skip to the benefits further down the page and read them first! 🙂

WARNING – BIRTHING DESCRIPTION BELOW 🙂

Your cervix may never have reached a dilation of 10cm before either, and this is the width it reaches when the baby’s head is passing through the cervix, therefore as the baby is crowning, the vagina must also expand to this width. 10cm is the maximum width the cervix can reach to allow baby’s head to pass through. The next part for baby’s head to pass through is the vagina and is preceded by the perineum bulging if you or a partner is looking using a mirror.

The following sensations as the baby nears the vagina is a build up of pressure, a burning sensation, warm compresses can help here to direct blood flow to the tissues around the vagina and help them stretch, or a midwife may perform some perineal massage at this point.

Crowning is experienced as an intense burning sensation, yet despite this, know that the baby’s head will be born within the next two contractions. Then followed by the shoulders and everything after that comes out easily and effortlessly, with many women not feeling a thing at that point.

The practice of perineal massage prepares, softens and stretches the tissues around the vagina opening in attempt to minimise tearing and vaginal trauma and even episiotomies. Think of it the same as any fitness workout you may do during the pregnancy to prepare for birth for your whole body, Perineal massage is training and preparation specifically for crowning.

Three Great Reasons to do Perineal Massage (Benefits)

1. Reduces pain during the birth
2. Reduces pain after the birth as the Perineum recovers
3. Reduces likelihood of episiotomies
4. Reduces Perineal Trauma ( Perineal Trauma affects sexual functioning)
5. Helps the tissues expand more easily during birth

The research study these points came from can be read here.

Perineal Massage Preparation

The perineum is the area between the anus and the vagina opening.

• Nutrition: Eating well, nourishing foods especially high in Vitamin C will contribute to resilient tissues that can stretch, repair and heal quickly.
• Begin at 34 weeks
• Do it yourself or get your partner to do it for you.
• Take a warm bath prior to practicing it to help you relax and direct blood flow towards your pelvic floor tissues.
• Mirror or no mirror – completely up to you

Hygeine

• Use vegetable oils such as coconut oil or olive oil anything pH neutral.
• Clean hands and short fingernails
• Do not perform Perineal Massage if you have active Herpes lesions or any vaginal infection
• Avoid the urethra (where you urinate) to avoid a UTI

The Perineal Massage Technique

• You can stand with one foot on a stool, bed or step or lie down on your back
• Insert your thumbs into your vagina, about one inchand press them towards your rectum (6 o’clock direction)
• Then out towards your thighs (“3 o’clock & 9 o’clock” if you can or “4 o’clock & 6 o’clock” directions is also fine)
• You should feel a stinging or burning sensation – but don’t be alarmed, with practice this sensation becomes less and less as you notice your tissues being able to tolerate more stretching each time you do it.
• Continue applying this pressure for two minutes until there is a more faint tingling or numbness.
• Depending on how comfortable you are with this, you can gently slide the fingers back and forth – the aim is to stretch the tissues outwards for another couple of minutes.
• If this is your second birth and you have had an episiotomy previously and have a scar, spend extra time massaging Vitamin E oil into the scar tissue.

The research states that if women implement birth preparation, the less likely they’ll need to use  Epidurals or Medicalised labour induction. It also says Birth Preparation promotes shorter labours, better pain management and a modified perception of pain during birthing. Wouldn’t this be a great thing to help your body do what it was designed to do, with less pain and more effective, productive stages in labour? Try Perineal Massage at home from your 35-36th week and know you’re setting yourself up best for birthing.

You can reach me at Spring Fertility HQ on info@springfertility.com.au if you want to discuss your birth preparation plan further and look at the other tools and techniques to incorporate.

Alternatively, you can check out my other blog posts on The Latest Research around Birth Preparation and how it improves birth outcomes or Using Acupuncture in the final weeks of Pregnancy.