Perineal Massage in Pregnancy

What is the Perineum?

The perineum is the area between the vaginal opening and the anus. This area stretches significantly during childbirth and may sometimes tear during vaginal delivery.

How common are perineal tears?

Approximately 40% to 85% of women who give birth vaginally experience some degree of perineal tearing. About two-thirds of these women may require stitches. Limited flexibility of perineal tissues can increase the risk of tearing during delivery.

Can perineal tears be reduced?

Research shows that perineal massage performed during the last weeks of pregnancy can reduce the likelihood and severity of tearing during birth. Regular massage helps relax and stretch the perineal tissues, keeping them flexible and better prepared for childbirth.

How is perineal massage done?

Perineal massage involves gently kneading and stretching the perineum. It is usually started from around 35 weeks of pregnancy and may reduce the need for an episiotomy when practiced regularly.

Steps for Perineal Massage

1. Wash your hands thoroughly with soap and water.
2. Cut your fingernails short to prevent injury to vaginal tissues.
3. Prop yourself comfortably in bed using pillows to support your back.
4. Use a lubricant such as vitamin E oil, almond oil or olive oil.
5. Place your thumbs about 3 cm (1 inch) inside the vagina, resting your fingers on the buttocks.
6. Press gently downward towards the anus and to the sides of the vaginal walls.
7. Hold the pressure until a mild stretching or burning sensation is felt.
8. Massage the lower half of the vagina slowly using a 'U'-shaped movement.
9. Continue massaging for about 10 minutes, twice daily.

Important Points to Remember

The goal is to gradually stretch the back portion of the birth canal towards the anus and then side-to-side using gentle, increasing pressure over time. The massage should not be painful. Mild burning or stretching sensations are normal initially.

Practicing slow breathing and awareness during the massage can help you feel more relaxed and in control, which may be beneficial during childbirth when similar sensations are experienced.