Why is Perineal Massage so Important in Pregnancy?

What are the benefits of Perineal Massage?

In the last 4-6 weeks of your pregnancy your body produces a final surge of Relaxin and other hormones to soften and lengthen your tissues. There are several benefits of working with your body’s new flexibility after 34 weeks to massage your perineum:

• Research tells us that perineal massage 2x per week can help you avoid perineal tearing or the need for episiotomy
• This has been proven for first time mothers
• Stretching the tissues at the entrance to your vagina will help you to recognise the stretching sensation as your baby moves down your birth path
• Perineal massage is a wonderful opportunity to practice your relaxation and deepening techniques

How do I perform Perineal massage?

 When

•  Start after 34 weeks.
• The best time is when you feel relaxed, perhaps after a warm shower or bath.

What position?

• Recline on pillows or stand with one foot on a stool. Reach down so that your thumb fits into your vagina (if it is difficult to reach your partner can help you to do this).

What direction do I stretch?

• Push your thumb downwards towards your anus and slightly sideways, about 2-5cm inside your vagina.
• Hold this stretch until your feel a stinging or burning sensation.
• Hold this for 1-2 breaths and then move to another position.
• Stretch points from 3 o’clock around to 9 o’clock (you might want to avoid too much pressure at the 6 o’clock position as it can be quite uncomfortable)

How often do I need to massage?

• Repeat this every few days.
• Some evidence says as little as 1.5x per week can make a significant difference. Other evidence says that results improve the more often that you perform perineal massage.
• A good compromise is to avoid massage every day (as this may irritate your tissues), but aim for every 2-3 days.
• Each time you massage aim to reach 5-10 minutes of stretching.

Do I need to use lubricant?

• If you massage and stretch one point at a time lubricant is not necessary.
• If you choose to move from 3 o’clock to 9 o’clock in a sweeping motion or with 2 thumbs at once, you may benefit form some lubricant
• Choose a natural lubricant free from chemicals or scent that is moisturising to your skin
• A warm compress can also help to relax these tissues

Perineal massage increases your awareness of this area of your body. Using a mirror can also be helpful to start with. However, once you become familiar with your body and the feeling of stretching you can relax, breathe and perhaps use some of your visualisations as you massage.

References:

Beckmann MM, Stock O. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Systematic Review (2013)

Jones LE, Marsden N. The application of antenatal perineal massage: a review of literature to determine instruction, dosage and technique. Journal Assoc Charter Physiotherapy Women’s Health (2008); 102: 8-11.

Written by Emily Shiel

Emily is one of our wonderful HypnoBirthing Practitioners in Albany, Western Australia. She is a Registered Physiotherapist with a special interest in women’s health. She is honoured to share each and every couple’s birthing journey with them and is passionate about helping women achieve the calm, natural and beautiful birth that they desire – as nature intended. Emily has provided antenatal education in the UK, USA and Australia since 1997.

Visit Emily’s website: http://www.shielphysio.com