The Expert Guide To Perineal Massage

Recent research has suggested that doing perineal massage can have a significant positive impact on women in vaginal birth.

By reducing the need for episiotomies and the severity of tears and trauma, it significantly improves the time it takes to physically recover from vaginal birth. 

It’s a no-brainer: there is no risk to you or your pregnancy and all the research (see the end of the article for just a small amount of the evidence to support this) suggests it can reduce the chance of having a serious tear. 

So how is this possible? The exercise (explained below) improves the elasticity of the muscles, allowing them to more easily stretch. It also makes you, the mum to be, more familiar and comfortable with the sensation of the stretching, so when this happens in labour, you are familiar with it.

In Ireland, we can still be a little weird about our own vaginas! But fear not women of Ireland, I have written this easy and handy (get it!) guide to help you prepare your amazing vagina to give birth. You wouldn’t expect to do a marathon without training your leg muscles, so why wouldn’t you train your perineal muscles for birth?

https://www.youtube.com/watch?v=Wm2aqVOG6Tc&feature=youtu.be

Firstly, to get our bearings, your perineum in the section of skin and internal muscles between your vaginal opening and your anus. This very underrated and amazing band of muscle can accommodate a whole baby's head, and with the right exercises, you can help it stretch and prepare for this amazing moment of birth.

You can do these exercises safely every day from about 34 weeks of pregnancy and can start as early as 32 weeks. You can do them yourself, or you can get your partner to do them. I know it sounds weird, but it can really build up trust between you and your birth partner and bring in some real intimacy, especially if your libido has fallen through the floor.  Obviously, only include your partner if you feel comfortable and want them involved.

  • Wash your hands thoroughly and make sure nails aren't too long or sharp.
  • Choose a comfortable position. This could be sitting or lying down, or you could try standing with one foot on a chair. You could even try doing the massage in the bath or shower, where the warm water will help to soften your perineum. Another way is to support yourself lying down with pillows under the back of your legs.
  • Get some suitable oil. There are special perineal massage oils that you can buy, or you can use some vitamin e or pure vegetable oil. Place a small amount on your fingers and thumbs, and around the entrance to your vagina.
  • Place your thumbs inside your vagina. Press them firmly towards your perineum and against the sides of your vagina until you feel a tingling.
  • Firmly massage in a U-shaped motion, to the point where you feel a slight burning sensation. Move from the sides of your vagina downwards to your perineum, and back up again. 
  • To start with, you should aim to do this for about a minute. But with practice, you may be able to continue the massage for up to 5-10 minutes, every day.
  • This should not be painful, but you should feel a slight burning, but you need to build up the time and pressure you use over time. 
  • Always stop immediately if you feel pain or are too uncomfortable.

Here is some more information:

https://www.ouh.nhs.uk/patient-guide/leaflets/files/10938Pmassage.pdf

https://www.hse.ie/eng/services/list/3/acutehospitals/hospitals/cavanmonaghan/instruction-leaflet.pdf

Here is some scientific evidence to support this:

https://www.cochrane.org/CD005123/PREG_antenatal-perineal-massage-for-reducing-perineal-trauma

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1403252/

https://www.lamaze.org/Connecting-the-Dots/what-is-the-evidence-for-perineal-massage-during-pregnancy-to-prevent-tearing

Avril Flynn

Avril is a Registered Midwife, Childbirth Educator, Hypnobirth Practitioner, Podcast and Live Event presenter and mother of one.

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