Perineal massage is a technique that can be used to reduce severe grade 3 and grade 4 tears with a vaginal childbirth. You will learn what perineal massage is, how to perform it, and additional tips and safety.
Perineal Massage
Perineal massage involves gently massaging and stretching the area between your vaginal opening and anus. Most tears will occur down towards your anus. It is rare for a tear to go up towards your urethra. Perineal massage is used to help reduce womens risk of severe grade 3 and grade 4 perineal tears, as well as episiotomies.
Perineal massage works to improve elasticity of your perineal tissues, increase blood flow, and soften the tissues so that they are more susceptible to stretch during childbirth. Also, think about any other muscle in your body. If you were to just drop down into the splits without stretching beforehand, do you think you could do it without tearing your inner thigh muscles? Most people can’t do the splits just on cue.
How to Perform Perineal Massage
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Find a comfortable position: You can sit propped up on your bed or in a warm bath.
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Lubricate your thumb: Add a small amount of coconut oil or non-scented lubricant to your thumb and perineal area.
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Insert your thumb about 1-2 inches inside your vagina.
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Massage in a U-shaped motion: Stretch the tissue by moving your thumb in a ‘U’ shape, holding the stretch for about 1 minute.
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If you can easily tolerate one thumb, insert two thumbs for a more intense stretch.
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You can insert your pointer finger/s if your thumbs don’t reach.
It’s advised to start perineal massage around 34 weeks of pregnancy. Aim for 5-10 minutes at a time, 3-4 times per week. If you experience any discomfort or have concerns, it’s a good idea to talk to your healthcare provider.
Additional Tips and Safety
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Warm up your perineum with a warm compress before you start.
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Relaxation is crucial. Take deep breaths and go slow.
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Get your partner involved if you’re comfortable. They can help with the massage, which can be both bonding and helpful.
If you have any medical conditions or are unsure, always check with your doctor before starting perineal massage.
References:
Venugopal V, Deenadayalan B, Maheshkumar K, et al. Perineal Massage for Prevention of Perineal Trauma and Episiotomy During Labor: A Systematic Review and Meta-Analysis. J Family Reprod Health. 2022;16(3):162-169. doi:10.18502/jfrh.v16i3.10575Akhlaghi F, Sabeti Baygi Z, Miri M, Najaf Najafi M. Effect of Perineal Massage on the Rate of Episiotomy. J Family Reprod Health. 2019;13(3):160-166.