Being pregnant introduces you to a whole new world – from ‘must-have’ purchases (god bless you, pregnancy pillow) to unwelcome beauty ailments (why are my lips so damn dry?). But one thing I did not expect to stumble across was ‘perineal massage’.
As soon as I divulged news that I was expecting, I received a flurry of helpful messages from friends. ‘Mama Mio Tummy Rub Butter will stop stretch marks!’, ‘you *have* to sign up to The Bump Plan‘, ‘don’t forget to do your pelvic floor exercises’ were some of the more welcome messages but one that stuck with me was ‘you need to do perineal massage’.
‘What is perineal massage?’, I nonchalantly Googled hoping to be met with videos of relaxing body massages. LOL. Instead, I was greeted with complex illustrations of the region between your vagina and bum with guides on how best to massage this area (or worse, get your partner to do it!) to ‘prepare the tissues to stretch over your baby’s head’ during birth.
As someone who is naive about birth and clearly has a very immature sense of humour, I found the whole concept hilarious and unnecessary but as I started speaking to more friends and reading more books, I realised my fate: I had to try perineal massage.
Still at a loss as to what the hell is actually was and how to perform it without injuring myself, I called on Jane Mason, founder of Natural Birthing Company, to break down the facts for me. I hope they save your blushes if you too are wondering WTF perineal massage is.
Firstly, what actually is the perineum?
“You might not know where the perineum is – lots of women I talk to don’t know either so you’re not on your own there,” Jane assured me. Phew. So what exactly is it? “Your perineum is the area of skin and underlying muscles that run between your vaginal opening and your back passage (anus). It is this area that stretches as baby’s head is born and similarly it is this area that tends to tear or will be cut during birth if the situation dictates.” Gotcha.
What is perineal massage?
“Perineal massage is the massaging of the perineum both on the inside and out in preparation for birth,” explains Jane, who advises to start any time from 34 weeks of pregnancy. “The massage should ideally be done 2-3 times a week, but if you want to do it every day then that’s perfectly acceptable too. It takes about 5-10 minutes to do and can be done by yourself or your partner if it’s more comfortable (it can get more difficult to reach the area as your bump grows) – some women like to incorporate it into the “intimates times” with their partner as it feels more natural to them.”
What are the benefits of perineal massage?
There aren’t yet a great deal of scientific studies into perennial massage, but it can:
- Reduce the risk of perineal tearing and damage
- Reduce the risk of episiotomy
- Prevent scarring
- Reduce postpartum pain associated with tears and trauma
- Reduce the risk of postpartum urinary incontinence and faecal incontinence
What can I use to perform the massage?
“Oil is needed as lubrication, our Down Below Perineal Massage Oil is perfect for this because it’s fragrance-free so is suitable for the sensitive area of your perineum, in fact it’s allergen free because it’s made from a carefully selected blend of natural plant oils (not even nut oils!) and because it’s been purposefully made for the job we’ve ensured with our chemists that it is perfectly safe to use for perineal massage,” said Jane.
How do I perform a perineal massage?
- The first thing is to make sure you (or your partner) have clean hands and short fingernails, that you have emptied your bladder and are relaxed in a place where you won’t be disturbed. Some women find a mirror handy to help visualise the area, whilst incorporating it into the bedtime routine after a bath or shower is also popular as it brings warmth to the tissues surrounding the area which helps the process. Positioning can be how you feel you’re most comfortable; semi –sitting, one foot up on the toilet, bath or stool, squatting against a wall.
- Next, place 1-2 drops of Down Below massage oil onto your fingers (forefingers & middle fingers) and apply to the outside of your perineum.
- Place your thumbs about 2 inches (5 cm] into your vagina.
- Press downwards with your thumbs in the direction of your anus so that you can feel the stretch of the muscles surrounding the vagina and the vaginal tissues. Once you have this downward pressure, use your thumbs to sweep from side to side in a rhythmic “U” shape/hammock movement. Whilst massaging the perineum from the outside with your other fingers. When massaging, apply steady pressure towards the anus. This may tingle, but should not hurt! This will also help you to recognise the sensation that you experience when your baby’s head begins to crown.
- Focus on relaxing your pelvic floor muscles as you massage, you will notice a difference in how it feels inside, it’s really useful to have an understanding of this when it comes to giving birth because a tense pelvic floor will, in a sense, fight against you trying to push the baby out!
- The perineum will possibly feel tight when you first start, but in time you will begin to feel a change as the tissues relax and stretch; remember this should not hurt! If your partner is performing the massage, just follow the same instructions but ask them to use their index fingers using the same “U” shape/ hammock motion. It is important to tell your partner how much pressure to apply.
- Finally, do not perform perineal massage if you are suffering from Herpes, Vaginal thrush or other known infections. Please contact your midwife or GP if you suspect any of these infections.
- All Midwives know about perineal massage and most will talk to you about it towards the end of your pregnancy so if you’re still unsure if it’s right for you check with your own midwife.
Why is it important and what may happen if I don’t perform it before birth?
“Perineal massage is important for expectant mums as it increases the elasticity of the perineum, meaning it will become more flexible to stretching during labour,” said Jane. She also explains that it improves the perineum’s blood flow and ability to stretch more easily and less painfully during the birth of your baby. “Tears in the perineum are less likely and you are less likely to need an episiotomy (a surgical incision made between the vaginal opening and the anus), which occurs in approximately 1 in 7 births in the UK.”
So will you be trying it?