Perineal Massage. Is it worth doing?

Let's talk about your vagina, after all, it's going to play a big part in your labour and birth.

Your vagina is designed to stretch and accommodate your baby during birth and return to the same size within just a few weeks after delivery. Your perineum — the skin between your vagina and anus — is slightly less elastic and may tear during delivery. It connects with your pelvic floor muscles. The pelvic floor muscles support your pelvic organs such as your bladder and bowel. During birth, the perineum stretches to make room for your baby.

Since your baby’s head needs to squeeze through a relatively small opening, you may be wondering if there’s any way you can prepare yourself or make it stretch a bit easier?

The good news is, YES!!

If you’re willing to put in a bit of work in the weeks before delivery, perineal massage just might help get you ready for birth.

What is a perineal massage?

Perineal massage is gentle, manual stretching of your perineum to prepare the muscles and skin between your vagina and anus for the birth of your baby. The goal is to reduce the risk of tearing when you deliver. Research suggests that massaging the perineum during the last few weeks of pregnancy can help increase muscle and tissue elasticity and make it less likely that you’ll tear during your baby’s birth. Tearing sounds scary but there is so much going on down there and competing tissue stimulus signals coming from different parts of your pelvis, vagina, uterus most women don’t feel the tear when it’s happening, even without an epidural. And most perineal injury heals well without any long term complications.

Does perineal massage really help with delivery?

Some evidence suggests that doing perineal massage during the last month of pregnancy can reduce the risk of vaginal and perineal tears and episiotomy (small cut to the perineum). But there haven’t been many studies, and the findings of these are inconclusive.

But it seems fairly logical that if you can reduce your risk (we can’t fully eliminate the risk) well that might be something to think about no matter how weird it all seems.

Personally, it’s more about getting used to that stretching sensation as it can be really intense for a minute or so that you don’t A – panic and go hell for leather pushing to get it over with and push through tissue that is not quite ready. Or B you freak out and tense up against the sensations. When you practice perineal massage it gets you used to the sensation so it’s not a shock and you can let it happen slowly and gradually and reduce your chances of tearing. Most mummas who do this feel more prepared for labour and would also do it again.

When can you start perineal massage and how often should you do it?

You can start to perform perineal massage from 34 weeks pregnant (check with your LMC) up until the birth of your baby. While advice on frequency varies, it is recommended that for maximum benefit you should massage daily, or at least on alternate days. It is important not to perform perineal massage if you have genital herpes, genital warts, thrush or any other vaginal infections.

Preparation for perineal massage.

• Wash your hands and ensure that your fingernails are trimmed to prevent scratching yourself

• Find a comfortable place, you may wish to sit propped up with pillows for support, either on the sofa or your bed.

• A good time to do perineal massage is after a warm bath as the blood vessels in the area are dilated and the perineum may feel softer and more comfortable to touch

• It's important to use unscented oil e.g. olive oil, sweet almond oil, coconut oil (although this does stain clothing), you need to avoid mineral oil or Vaseline. Alternatively, you can use a water-based lubricant - although this needs to be reapplied more frequently than oil

• If you are doing the massage alone you may wish to use a mirror to help to see what you are doing. Alternatively, if you are both comfortable with the idea, you may wish to ask your partner to massage for you.

How to perform perineal massage.

You may feel some stretching sensations during the massage, but this should not be painful. Stop if you experience pain and chat with your LMC or healthcare provider.

• Lubricate your thumbs or fingers with your chosen oil/lubricant and insert 2-3 centimetres inside your vagina

• Press your thumbs or fingers down towards your anus, then move the thumbs or fingers in an upwards and outwards movement; in a rhythmic “U” shaped movement (from about 3 to 9 o’clock, if you imagine a watch).

• Try to relax the pelvic floor muscles as much as possible during the massage. This will allow the perineum to stretch more.

• The massage can last as long as you wish but try and aim for around three to five minutes each time.

Benefits of perineal massage.

While the benefits of perineal massage still haven’t been proven through scientific studies, it may:

• 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 fecal incontinence

Disadvantages of perineal massage.

There are a number of potential downsides of perineal massage:

• It might not work

• It takes time and persistence

• Massaging too hard can boost blood flow to an area that’s already engorged with blood, which can increase inflammation and lead to irritation, discomfort and pain

Postnatal Care

After your baby arrives, caring for your perineum is essential for comfort and healing. Our Peri Spray is specifically designed to soothe and refresh the area, helping to reduce discomfort and promote faster healing. It's a gentle, natural solution to support you during the postpartum period, and a perfect addition to your recovery routine. Order your Peri Spray today and experience the relief you deserve!

Yes, it’s one of the less glamorous aspects of birth preparation but the majority of people say they found perineal massage useful especially to increase their tolerance and confidence for those intense sensations during stretching.

So have a go - you’ve nothing to lose and lots to gain!