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PERINEAL MASSAGE: WHEN TO START PERINEAL MASSAGE AND HOW TO DO IT

Updated: Aug 1, 2023


oil to use during perineal massage

Alright, let's talk about perineal massage, a nifty technique that involves giving your lady bits some love and attention before childbirth. Basically, it's all about gently stretching and massaging those perineal muscles to make them more flexible and reduce the chances of vaginal tears and trauma down there.


Here's the deal: studies(1) have actually shown that perineal massage can be a game-changer, especially for first-time mums. It can help lower the risk of perineal trauma during childbirth, meaning fewer tears and stitches. Who doesn't want that?


Perineal massage involves massaging the perineum to increase its flexibility and reduce the likelihood of tearing or needing an episiotomy during childbirth. In this article, we will outline the following:

  1. What is a perineal massage

  2. How to do a perineal massage (including when to start, how often to perform it, and correct positioning)

  3. Perineal massage tips

  4. Frequently asked questions / FAQs

What is Perineal Massage?

Perineal massage is a technique recommended for pregnant women to help prevent perineal trauma during childbirth. The perineum is the area of skin and muscle between the vaginal opening and the anus, and the massage involves stretching and massaging these muscles to increase flexibility and reduce the risk of tearing or needing an episiotomy during delivery.

I was really unsure whether perineal massage helped or not, so I spent some time chatting to my woman's health physio to understand the latest research. Now I am am massive advocate. Helen, Founder, Rock Me Momma

Research studies have shown that perineal massage can be effective in reducing the incidence of perineal trauma during childbirth, particularly in women who are giving birth for the first time - A study by Beckmann & Garrett(2) found that perineal massage during pregnancy can reduce the likelihood of perineal trauma during childbirth by 10% for first-time mums (this benefit was not seen in women giving birth vaginally for the second time). Additionally, another study published by the NHS(3) found that perineal massage can reduce the need for pain relief during and after labor.


Now, hold your horses! Before you start going all masseuse on yourself, it's crucial to have a chat with your healthcare provider. They'll guide you through the process and make sure it's safe for you.


Where is the Perineal Area?

The perineal area is the skin and tissue that lies between the vagina and anus. The perineum includes the pelvic floor muscles, which support the bladder, uterus, and rectum. The perineal area is also rich in nerve endings, and stimulation of these nerve endings during perineal massage can increase blood flow to the area and help reduce discomfort and pain.


Vulva and perineal area for perineal massage

Is a Perineal Massage Painful?

Perineal massage should not be painful, but it can cause some discomfort or a stretching sensation. If you experience pain during the massage, you should stop and consult with your healthcare provider. It is important to communicate any discomfort or pain during perineal massage with your partner or doula to adjust the pressure and technique to make it more comfortable.


Benefits of A Perineal Massage

Here are some of the potential benefits of perineal massage during pregnancy:

  1. Reduced risk of perineal tears(4): Perineal massage can help to stretch and relax the muscles of the perineum, reducing the likelihood of tearing during childbirth.

  2. Lower likelihood of needing an episiotomy: An episiotomy is a surgical cut made to the perineum during childbirth to help facilitate delivery. Perineal massage may help to reduce the need for this procedure; a 2006 study(5) found that Perineal massage in the weeks leading up to delivery helps some women avoid episiotomy

  3. Improved pelvic floor function: The pelvic floor muscles are essential for bladder and bowel control, as well as sexual function. Perineal massage can help to strengthen and tone these muscles.

  4. Increased comfort during pregnancy: Massaging the perineum can help to relieve discomfort and pressure in the area, which is common during pregnancy.

  5. Increased confidence during childbirth: By preparing the perineum for delivery, women may feel more confident and empowered during childbirth.

It is important to note that not all women may experience these benefits and that perineal massage may not be suitable for everyone. As always, it is recommended to consult with a healthcare provider before attempting perineal massage.


How to Do a Perineal Massage?

Before starting perineal massage, it is essential to wash your hands thoroughly. You can also use a lubricant or oils suitable for perineal massages(6), such as jojoba, avocado and peach kernel oil, to make the massage more comfortable.

Perineal Massage Guide

To perform perineal massage, you can follow these steps:

  1. Find a comfortable position. You can try sitting with your back against a wall or propping yourself up with pillows.

  2. Insert your thumbs or index fingers into the vagina. It is best to trim your nails and make sure your hands are clean before starting the massage.

  3. Press down gently towards the anus and then pull your fingers towards the sides of the vagina. You should feel a stretching sensation but not pain.

  4. Hold the stretch for up to two minutes.

  5. Release and repeat the massage on the other side.

  6. You can also try pushing down and out on the perineum with your fingers to stretch the muscles.

It is best to perform perineal massage for around five to ten minutes per day.


If you're struggling to reach you could also ask your partner to assist you with the massage or book in a session with a woman's health physio.


When to Start Your Perineal Massage

Kick-start the massage routine around 34 weeks into your pregnancy for maximum effectiveness. Starting earlier than this can cause discomfort, while starting later may not allow enough time to make a significant difference. A Cochrane review of perineal massage during pregnancy found that starting perineal massage at around 35 weeks can reduce the likelihood of perineal trauma during childbirth.


How Often to Do a Perineal Massage

Perineal massage can be done every other day, for five minutes each time, but even performing a perineal massage once or twice a week can have positive effects.


What is the Easiest Position for a Perineal Massage?

Finding a comfortable position for perineal massage is essential to make the massage more effective and comfortable. Some of the most common positions for perineal massage include:

  • Sitting with your back against a wall or sitting on a cushion with your legs apart

  • Lying on your side with your knees bent

  • Getting into a comfortable position with the help of a partner or doula.

  • Sitting in the bath

What Oil Can You Use for a Perineal Massage?

Recommended oll for perineal massage

When performing perineal massage, it is recommended to use oil to make the massage more comfortable. A study published in the Iranian Journal of Nursing and Midwifery Research(7) found that using a lubricant during perineal massage further reduces the need for episiotomy.


There are many different oils that can be used for perineal massage, each with their own unique benefits. Oils don't only help to make more comfortable, they can also help promote skin elasticity and some can help reduce discomfort or irritation in the perineal area. Some of our recommended oils include:

  1. Sweet Almond Oil: This oil is light and easily absorbed into the skin, making it a popular choice for perineal massage. It is rich in vitamin E, which can help to improve skin elasticity and reduce the risk of tearing during childbirth.

  2. Jojoba Oil: Jojoba oil is similar in composition to the natural oils produced by the skin, making it a good choice for sensitive skin. It has anti-inflammatory properties that can help to soothe any irritation or swelling in the perineal area.

  3. Grapeseed Oil: Grapeseed oil is a light, non-greasy oil that is easily absorbed by the skin. It is high in antioxidants, which can help to protect the skin from damage and promote healing.

  4. Coconut Oil: Coconut oil is a popular choice for perineal massage due to its moisturising and antimicrobial properties. It can help to soothe and protect the skin, and may also help to prevent infections.

  5. Olive Oil: Olive oil is a natural moisturiser that can help to improve skin elasticity and prevent tearing during childbirth. It also has anti-inflammatory properties that can help to reduce swelling and irritation in the perineal area.

  6. Avocado Oil: Avocado oil is rich in monounsaturated fatty acids, which can help to improve skin elasticity and reduce the risk of tearing during childbirth. It also contains vitamins A, D, and E, which can help to promote healthy skin and prevent damage.

Our perineal bits oil is made with our special blend of oils including sweet almond oil, jojoba oil, avocado oil and peach kernel oil to promote maximum elasticity.


As with any oil, it is important to patch test on a small area of skin before using it for perineal massage, as some women may be allergic to it.


Perineal Massage Tips

Perineal massage can be challenging to perform, especially for first-time parents. To help make the experience more comfortable and effective, follow these tips:

  1. Use a lubricant: Applying a small amount of lubricant to the perineal area can make the massage more comfortable and effective. This can be a natural oil like sweet almond oil or coconut oil, or a water-based lubricant.

  2. Start slowly: Begin with gentle pressure and gradually increase over time. This can help to prevent discomfort or pain in the perineal area.

  3. Breathe deeply: Deep breathing can help to relax the muscles and make the massage more comfortable. Take slow, deep breaths in through your nose and out through your mouth.

  4. Communicate with your partner: If your partner is helping out, then make sure you communicate with them throughout the massage to ensure that you are both comfortable and that the pressure is not too much. Let your partner know if you need them to slow down, use less pressure, or stop altogether.

  5. Take a warm bath: Soaking in a warm bath can help to relax the muscles and make the massage more comfortable. Make sure the water is not too hot

  6. Don't force it: If the massage is uncomfortable or causing pain, stop immediately. Perineal massage should never be painful, and you should always listen to your body.

FAQs


Why can't you do perineal massage before 34 weeks?

Before 34 weeks, the perineal tissues may not be fully ready for stretching, and premature perineal massage may not provide the intended benefits. It's best to start at 34 weeks when the tissues are more prepared for stretching.


Does perineal massage reduce the risk of tearing during childbirth? Yes, it can reduce the risk of severe tearing and the need for episiotomy.


Can perineal massage be helpful for those having a cesarean section? It can help with pelvic floor muscle awareness but is more beneficial for vaginal deliveries.


Is perineal massage safe, and are there any risks involved? It's generally safe, but consult a healthcare provider if you experience discomfort or have medical conditions.


Can I perform perineal massage if I have certain medical conditions or complications during pregnancy? Consult your healthcare provider before attempting perineal massage with any medical conditions or complications.


Is it necessary to have a partner to perform perineal massage? No, it can be done alone.


Are there any other benefits of perineal massage during pregnancy? Yes, it promotes relaxation, increases blood flow, and helps mentally prepare for childbirth.


Does perineal massage work?

Yes, perineal massage has been shown to work effectively in improving perineal flexibility and reducing the risk of severe tearing during childbirth.


Can I do perineal massage in the bath?

Yes, perineal massage can be done in the bath, but it's important not to add any toiletries such as bubble bath or shower gel


Can I use coconut oil for perineal massage?

Yes, coconut oil is a natural oil and can be used as a lubricant for perineal massage. However, it's essential to ensure that you are not allergic to coconut oil and that it suits your skin.


Can perineal massage bring on labour?

Perineal massage is not intended to induce labor. It aims to prepare the perineum for childbirth and may have some relaxing effects, but it does not typically initiate labor.


Can perineal massage reduce labour?

Its primary purpose is to prepare the perineal area for childbirth by increasing its flexibility and elasticity, potentially reducing the risk of severe tearing during delivery. Perineal massage can help to relax the perineal muscles and tissues, making it more pliable during childbirth, but reducing the overall duration of labor is not one of its intended effects.


Can perineal massage cause bleeding?

Perineal massage is generally a gentle technique, but in some cases, it may cause mild spotting or bleeding. If you experience significant bleeding or pain, stop the massage and consult your healthcare provider.


Summary

Perineal massage brings a whole bunch of benefits to the pregnancy party. It can decrease the likelihood of vaginal tears or an episiotomy (ouch!), improve your pelvic floor function (hello, postpartum bladder control), make you more comfortable during pregnancy, and boost your confidence when the big day arrives.


Before you start going all masseuse on yourself it's worth having a chat with your midwife or healthcare provider to guide you through the process.


So, if you're up for some self-care down there, consider giving perineal massage a try. Your lady bits will thank you, and you'll be ready to rock that childbirth like a boss!


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