P is for Perineum

Prior to having babies you probably don’t ever think about your perineum but when you’re pregnant suddenly you will find your midwife talking about it like its public property.

Perineal massage is a word you will find most pregnant ladies cringe to or screw their face up at when spoken about. Given that it is only spoken about in the last trimester of pregnancy it is one of those embracing pregnancy words that that only gets whispered about or swiftly addressed at antenatal classes and forgotten about, quickly.

I have been wanting to write about the importance of perineal massage for sometime now, as I know many of you don’t really want to discuss this with your friends or family. As much as I discuss perineal massage with my birth doula clients I am hoping that this little step by step guide will help all of you pregnant ladies.

Your perineum (or central tendon) is the piece is the muscle and tissue that lie between the bottom part of the vagina and the anus. It is the center point at which almost all the muscles of the superficial layer of the pelvic floor converge. However, most people broaden this area and refer to the skin and muscles between the vaginal opening and the anus as the perineum. Perineal massage is a massage of these muscles for the purpose of softening the skin and improving elasticity  and flexibility to help prevent tears and stitches during childbirth. As well as this it stimulates blood supply and helps speed healing process after birth.

Scientific studies have confirmed that regular massage of the perineum in the last trimester about 32+ weeks or so is beneficial to help the mother release tension and help ease the stretching of the perineum during labour. The best time to start perineal massage is around 32 weeks pregnant.

Perineal massage can cause some stinging sensation which is believed to help the mother become familiar and comfortable with the intense stinging that occurs as the baby’s head is crowning. Perineal massage can be repeated daily, and in about a week, you will probably notice increased “stretchiness” in your perineal area.

Instructions for perineal massage during pregnancy

  • I would recommended you to use a water soluble lubricant for this massage such as  olive oil, almond oil or vitamin E oil . Do not use baby oil, mineral oil, or petroleum jelly.
  • Start once you have had a bath or shower as you’ll be more relaxed and the tissue will be softer and more comfortable to touch.
  • Prop yourself up against some pillows, you can use a mirror if this helps.
  • Place your thumbs about 3cm inside your vagina.
  • Press your thumbs downward towards your rectum and sideways firmly but gently until you feel a tingling. Being too vigorous could lead to swelling or bruising.
  • Hold this stretch until the area begins to feel a little numb (around two minutes).
  • With your thumbs maintaining a gentle steady pressure, gently massage the lower half of the vagina using a “u” shaped movement
  • Continue massaging this area slowly for around 5-10 minutes, being careful to avoid the urethra (urinary opening). This is a good time to practice slow, deep breathing techniques.
  • If your partner is doing the perineal massage, follow the same basic instructions, above. However, your partner should use his or her index fingers to do the massage (instead of thumbs). The same side-to-side, U-shaped, downward pressure method should be used. Good communication is important be sure to tell your partner if you have too much pain or burning!
  • Continue this once or twice a day, after a week you will notice an increase in flexibility and stretchiness

Happy Massaging!

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