What is perineal massage?
Perineal massage is a technique used to increase flexibility and decrease sensitivity of the outer layer of pelvic floor tissues in preparation for vaginal delivery.
What is the perineum?
The perineum is the tissue between the vagina and anus. Many pelvic floor muscles attach here. It’s also the area where tearing is most likely to occur during vaginal delivery.
Why perform perineal massage?
Research suggests that perineal stretching can reduce the risk of severe perineal tears during first vaginal deliveries. Many people also benefit from the mindful relaxation and focus on the perineal area in preparation for birth. Even if it’s not your first vaginal delivery, you may find perineal stretching helpful!
HOW TO PERFORM PERINEAL MASSAGE
Most people choose to begin around 32-34 weeks of pregnancy.
We do not recommend this practice if you are on pelvic rest restrictions or at risk of preterm labor.
- Your preferred lubricant or natural oil (e.g. coconut oil, extra virgin olive oil)
- Towel for clean up
- Empty your bladder if you need to. There is no need to go “just in case.”
- Lay in a supported, reclined position with knees in a “butterfly” shape. Use pillows to support you and help you fully relax.
Perineal Massage Technique:
Most people are unable to reach their vagina at this point in the pregnancy. A partner will probably be helpful! If you’re able to reach by yourself, use your thumb. A partner should use their index finger.
Imagine the vaginal opening as a clock: 12:00 is towards the pubic bone and 6:00 is towards the anus.
- Insert a lubricated finger into the vaginal opening up to the first knuckle.
- Begin by applying gentle but firm pressure down towards the 6:00 position.
- As you feel pressure, practice relaxing into the sensation. As you feel your perineal muscles relax, you may be able to sink deeper into the stretch. Most people hold this stretch for 1-2 minutes.
- Repeat this process at 5:00 and 7:00, drawing diagonally down towards each sit bone. You may choose to repeat this cycle in the 5/6/7:00 positions.
- If it is comfortable, you can also apply pressure in a sweeping motion from 4 to 8:00, in addition to the sustained pressure described above.
- After you are done, wash away the lubricant.
The goal is to feel a strong but comfortable stretch. This means no more than 4/10 discomfort. Reduce your pressure if needed. If someone is performing this massage on you, communicate clearly to help them find the right pressure.