Perineal Massage - Benefits & How-To
Photo by Ben Sweet on Unsplash (haha, I thought this was so perfect)
So many women in our culture grow up without ever having seen a birth until it's time for the birth of their own child. This leads to fears and uncertainty about "how will this GIANT baby fit through that little hole?!" The truth is, our vaginas are amazing & stretchy & totally capable of birthing a child.
That being said, many women do experience some tearing during childbirth, which if severe can be painful during the postpartum recovery period. The good news is that there's something you can do to reduce the risk of tearing and episiotomy!! It's called Perineal Massage.
But what's the perineum, anyway?
The perineum is the soft skin between the anus & vagina. It also happens to be where you can find your first chakra (your first chakra is related to your basic needs, safety, ground, and your foundation). The perineum is prone to tears during a vaginal birth because it is so close to the vagina & needs to streeeeetch to allow your baby to come into the world.
What are the benefits of perineal massage?
The benefits of perineal massage are twofold - the first is that it helps reduce anxiety during the pushing phase by allowing you to understand how it might feel in that area when your baby's head is stretching your perineum. Second, research shows that doing perineal massage for 5 minutes 1-2 times a week starting at 34 weeks can reduce the risk of perineal trauma & ongoing perineal pain (see here for more details on the research). Disclaimer - research on this topic is still somewhat sparse, but from what we do know so far it does seem to help. That being said, I always recommend consulting with your caregiver before trying anything!
How to do Perineal Massage
If you're a visual learner, check out this Youtube video. I also like MamaNatural's pictures here.
Most experts recommend starting perineal massage at around 34 weeks of pregnancy, and doing it 1-3 times a week for 5 minutes each time. You can ask your partner to help you (some couples actually find this to be a really fun activity and a good way to get the partner involved in childbirth prep) or you can do it yourself! In terms of positioning, you can sit up cross-legged on the bed, stand up in the shower, or lie down on the bed if your partner will be helping.
1. Take a warm bath or shower. That can help to soften the perineal skin in preparation for the massage. This step is optional, but relaxing & nice.
2. Apply some oil or lubricant to the perineum (no need to buy anything fancy, any non-toxic oil like coconut or sunflower will work).
3. Insert your thumb in the vagina, up to your first knuckle. Press downward towards the anus for about 1-2 minutes. Apply enough pressure that it's uncomfortable (slight burning/stretching is ok), but not painful.
4. Next, insert both thumbs into the vagina up to the first knuckle and press each thumb outward (away from the center of the vagina). Hold here for 1-2 minutes.
5. Repeat 1-3 times a week for 5 minutes each time!
Other Ways to Support the Perineum in Labor
Hopefully I've sold you on giving perineal massage a try. But there are also other things you can do in labor to try to minimize the risk of tearing during the pushing stage. Results have been mixed regarding the following strategies (see this DONA article), but I think they're worth discussing with your care provider. First, ask your caregiver about whether they are willing to support your perineum with a warm compress while you are pushing. You can also ask about whether they think applying some oil to the perineum during pushing will help. Lastly, positioning during pushing may play a role.
Thank you so much for reading, and please reach out to let me know your thoughts!
Claire Baker Madison Doula