Perineal massage is a procedure that can be used to increase the likelihood of avoiding the need of an episiotomy in childbirth. Although in most of the hospitals in the area, routine episiotomy is no longer practised, a stretched and relaxed perineum will reduce the risk of an episiotomy even further.
How does it work?
The massage process stretches the Perineal tissues and relaxes them, which results in less resistance to the birth of your baby and the need to cut into the tissue for delivery. Whilst doing the massage a women can identify her pelvic floor muscles and learn to relax them. Using oil during the massage will also help to soften the tissues and make them more elastic. The best time during pregnancy to start this type of massage is at about 34 weeks, although any massage done during labour can help.
Instructions on how to do Perineal Massage.
The best time to do this is after bathing and use any of the following oils: wheat germ, olive, almond* or vitamin E. The Body Shop stocks most of these as will a good chemist, but make sure any oil you use is pure. Your perineum is the area of tissue between your vagina and your back passage. Before starting the massage whether you are doing it yourself or your partner is doing it for you, make sure you are in a comfortable position, maybe leaning back on pillows. If you are doing it yourself you may need a mirror.
* do not use if any history of allergies.
Once you are in a comfortable position, apply lubricant to either your thumbs or your Perineal area. Place your thumbs about 1 – 1.5ins inside your vagina and push your Perineal floor towards your back passage and to the side. Gently stretch the opening, pressing down until you feel a slight tingling or burning sensation. At this point maintain the pressure and stretch for a couple of minutes until the area becomes numb. Then slowly and gently work the lubricant in with your thumbs using a rhythmic ’U’ or sling type movement, still maintaining the pressure and stretch. Avoid the urethral area because of potential infection. Massage for about 3 -4 minutes, paying particular attention to any existing scar from a previous cut or tears. If you pull the perineum forward while doing the massage, you will be mimicking the action of the baby’s head as it emerges. Do the massage once a day after about a week you will notice an increase in your perineum stretchiness and flexibility.
Your partner should do the massage by inserting his two index fingers to press the perineum down and to the sides. After the burning sensation diminishes, he should massage with his index fingers and thumbs outside, working over any scar tissue area. The massage action maybe side to side, by a sweeping motion in opposite directions. If the women is semi-sitting with the pubic bone at 12o’clock, the massage will go from about 6 to about 4 and 8 o’clock. The partner needs to be both flexible and sensitive to the woman’s needs and feelings.
Thanks to North Surrey midwives for sharing this