Perineal Massage

The thought of tearing during childbirth or even worse, being cut, is enough to make any woman wince, so any way to reduce the chances of stitches has to be worth consideration.

Perineal massage is one such trick that has been linked with huge benefits in a number of studies worldwide. Yet it is one of the simplest self-administered therapies to try.

What is the perineum?

The perineum is the strip of skin between the vaginal opening and the anus. During childbirth, it comes under enormous pressure. In births that are traumatic or difficult, or even with a large baby, the perineum can burst open, splitting considerably and requiring stitches post-delivery. In some cases, when the baby cannot make the final push out into the world, an incision may be made into this area, usually with a local anaesthetic. This is called an episiotomy.

Episiotomies are no longer commonplace and in some cases, doctors prefer to let a women tear while giving birth as there has been some evidence that healing is better, with less post-birth pain. However, the risk of tearing naturally is that the perineum could rip right along, putting the mother at risk of developing third degree tearing.

Flexibility and the perineum

While there are never any guarantees about how a birth will progress, research has revealed that women who have practiced perineal massage not only stand more chance of avoiding a tear in this area, but also that they feel less panicky about the strange sensations down below when the baby is crowning.

The changes that a woman's body undergoes during pregnancy are unbelievable. Many of these are ultimately helping to prepare for childbirth. One of the differences that many women may notice is that they become more flexible. This is due to a hormonal change that occurs throughout pregnancy. The amounts of the hormones relaxin and progesterone increase in expectant mothers during pregnancy to loosen up ligaments as well as softening muscles. This change is designed to help the body accommodate the transition of the baby through the birth canal. This new found stretchiness extends to areas such as the perineum.

Stretchiness and flexibility are undoubtedly a pregnant woman's friends, as these are two attributes that will help childbirth progress with fewer complications and fewer medical interventions. Perineal massage simply takes advantage of the changes occurring in the body, maximising the effects of flexibility to help the perineum ready itself to thin and stretch during labour.

The benefits of perineal massage

Perineal massage increases blood flow to the area, which in turn, automatically improves elasticity and stretchiness in preparation for childbirth. But as well as increasing the flexibility within this area, it also has other benefits that can be equally as useful.

Let's face it, no matter how ready you think you are for childbirth, there is little that can truly prepare you for the stinging sensation in your pubic area coupled with the increasing pressure and urge to push. The shock of the feelings can make many women feel extremely panicky, which in turn can cause a tightening up or tensing down below at the critical time. Perineal massage helps to acclimatise you to the sensations of tingling and pressure, which will help you to stay calm during labour, something which is not always easy, especially for first time mums.

Check that perineal massage is OK for you

Perineal massage is safe for nearly every expectant mum, but there are a few exceptions. Any pregnant women with active herpes lesions, thrush, or other kind of vaginal infection should avoid perineal massage due to the risk of spreading the condition within the genital region. It is also essential to make sure you fully understand what to do and avoid the urinary tract opening, as this can cause an infection.

How to massage your perineum

Many antenatal classes cover perineal massage techniques, or your midwife should be able to help explain the right way to do it. However, as a rough guide, perineal massage involves stretching the area by inserting two thumbs into your vagina by approximately an inch and pressing downwards and to the side. It is important to keep pressing and gently stretching until you can feel a slight stinging or burning sensation and then hold that position for a couple of minutes. This should cause the perineum to start to go numb and the stinging to subside. You should then slowly massage the lower part of your vagina, maintaining the pressure, moving to and fro with your thumbs and pulling slightly outwards at the same time.

It is essential to use a suitable oil, either vegetable oil or olive oil is fine, but it is also possible to buy specific perineal massage oils or even vitamin E oil, if you prefer. It is a good idea to start the massage around 6 weeks before your due date and the easiest way to access the area is by lying on your side and reaching behind. Some women find it more comfortable to recline on their back against cushions. Depending on the size and position of your bump, perineal massage may become more awkward to perform as the weeks progress, so many women ask their partners to oblige in the latter stages.

It has to be said that the description of perineal massage does not sound particularly inviting, no matter how you phrase it and it can be tempting to give it a miss. However, compared to the potential pain at childbirth, the slight discomfort is nothing. Giving yourself the chance to not only avoid tearing but also post-delivery pain several months after the birth (a real problem for some women who need stitches) is one of the best things you can do to get your body back to normal as quickly as possible.