What to know about Perineal Massage
Pregnancy is a journey like no other!
There are many physical changes that the woman’s body has to go through to grow a baby.
Once the baby has spent 9 long months developing in the womb, getting it out and into the real world is another story.
Labour and delivery is a strenuous time in a woman’s body!
Not only have her bones and ligaments stretched to accommodate the growing baby, the organs around the uterus shifted in position, and the hormonal balance being messed about like a seesaw over the past 9 months, now she has to endure pushing the baby out.
No one ever said pregnancy was fun and games!
The average time of labour is 8 hours, the equivalent of a standard working day. However, this isn’t time spent in a dull office. Rather, during this time, the cervix has to dilate from 1 centimeter to 10, the size of a sesame seed to a donut.
The cervix is what connects the internal uterus to the external part of the vagina and the cervical canal is where the baby will pass through.
This part of the body is generally a sensitive one, without the strain of a baby pressing on it.
To help the cervix dilate and the vagina stretch during pregnancy, a technique used perineal massage is often recommended.
Here is more information about perineal massage and why it can be worth considering.
What is perineal massage?
The muscles found between the bottom and the vagina are called the perineum. These have to do a lot of stretching and pushing to get the baby out during labour.
This isn’t a standard movement for these muscles so there can be a risk of tearing or excess strain on them.
Perineal massage is a technique used to loosen these particular muscles. It can be daunting for some women as this massage involves internal touching.
The perineum is literally in the area between the vagina opening and the anus. However, massaging this region can encourage elasticity and reduce the risk of perineal trauma.
How is perineal massage done?
Since this is massage for a sensitive area, there are certain techniques and strategies used to ensure it is done properly.
Women can do perineal massage themselves, so long as they are comfortable and able to stretch their body without hurting anything.
Otherwise, they can have their partner do it. Feeling comfortable and relaxed with either arrangement is the most important thing to get right.
The first thing to note is that the hands need to be clean.
It is also more comfortable if the nails are cut so that they don’t cause irritation.
It isn’t necessary to wear gloves, as this can also be more uncomfortable and less lubricated, but the hands need to thoroughly scrubbed and cleaned.
Perineal massage can be done standing up or lying down, as long as the woman is comfortable and relaxed.
It can be done in the shower or a bath. A common position is standing up with one leg on a chair, like inserting a tampon.
Often, women use a mirror if they are doing it themselves. This allows them to have a better view of the vaginal area and where they are inserting their thumbs.
A floor to ceiling works best if the woman is unfamiliar with the perineal area.
Using some vitamin E cream or pure oil, such as vegetable or olive oil, on the fingers and thumb, the thumb then goes inside the vagina. Then press firmly towards the perineum and against the sides of the vagina. There may be a light tingling feeling which is normal.
The massage motion should be done in a firm U-shape.
Moving from the sides of the vagina to the perineum and back, the best amount of time is to do this for a minute.
Once it becomes more comfortable and feels natural enough, it can be done for longer.
Keep a clean towel handy to wipe fluids off the hands afterward.
When is the best time to start perineal massage?
This technique is mostly used in the preparation for labour and delivery. Therefore, it is recommended to start perineal massage at around 34 weeks.
This helps to relax and strengthen the perineal muscles before they have to stretch like they’ve never stretched before.
It is recommended to do perineal massage once a week starting at the 34-week mark.
If it is possible to do it twice a week, that is even better.
It doesn’t need to be done any more than this to reduce the risk of a tear even further. However, doing it more than twice a week can reduce the pain in the perineum during the healing process after giving birth.
What are the benefits of perineal massage?
Aside from reducing the risk of perineal tearing, there are many other benefits for women.
By loosening the muscles and creating an enhanced degree of elasticity, it means that the perineum can heal quicker after giving birth, causing less pain in this region.
Perineal massage also reduces pain when the baby is crowning. This is because the gentle massage stretches the area, which makes the vagina able to stretch and adapt for the baby’s head to come out in a less intense manner.
It also means that the baby’s head might come out quicker, speeding up the whole delivery. This varies from woman to woman, however.
Perineal massage also reduces the need to have an episiotomy. This is a surgical cut between the vagina and anus to make the opening wider. Perineal massage is thought to reduce this risk by up to 15% for first-time mothers.
Is perineal massage worth trying?
It is very much a personal choice for women if they try perineal massage.
There are many benefits and little harm that come from it.
Although it might be uncomfortable at first, the fact that it reduces pain during labour, makes it easier for the baby to crown, and aids the healing process of the perineum after giving birth are reasons enough to give it a go.
Perineal massage is also another way to feel in touch with the pregnant body and understand different pressure points.
It can help an expectant mother know what the area feels like that the baby is going to come out and better grasp just how the delivery process will affect her physically.
Perineal massage is also thought to help the woman relax during the crowning process and be less sensitive to the stinging sensation as they are more used to sensations around the perineum.
Is perineal massage safe?
In general, this is a safe thing for women to do at home, or have their partners do.
The most important thing is that the hands are thoroughly cleaned and the massage is done in a safe, comfortable, and hygienic environment.
For low-risk pregnancies, there shouldn’t be any concerns with perineal massage. However, for pregnancies that have had any complications, or if there are any concerns, it is best to check with a doctor before doing it.
Even in low-risk and normal pregnancies, chatting to the gynaecologist or obstetrician about perineal massage is a good option.
They can also help with guiding the process and talking about the best techniques to use. Having a professional opinion never hurts in the long run.
One thing to be aware of is having a positive mindset!
Thinking too much about a potential tear or fearing the process of labour, for this reason, can be harmful.
Perineal massage is a preventative technique, but a tear to the perineum is not something to dwell on and fear.
Being preoccupied and worried about perineal tearing can cause stress and tension, which ironically makes the perineum more likely to tear.
Using this technique should also be done in conjunction with relaxing the mind and keeping a positive attitude about labour and delivery.
Will perineal massage work?
Ultimately, what a perineal massage is trying to do is prepare the elasticity in the perineum. It should work, but there is no guarantee.
Giving birth is an unpredictable force of nature.
Things can go wrong no matter how prepared a woman is for the process.
So, even by regularly massaging the perineum, there may still be a tear or the need for an episiotomy.
Perineal massage by no means guarantees a comfortable and easy labour. It won’t for certain make the crowning process easier or help slide the baby’s head out like it’s no one’s business.
There is nothing that can guarantee things like that with labour and delivery!
Nonetheless, it is something worth trying!
There is little harm to come from trying perineal massage.
Research shows that the only time it can be negative is if it is done excessively and with too much force.
Otherwise, it is a simple process that doesn’t take too much time out of the day and can give a chance of making labour and delivery smoother.