Perineal Massage During Pregnancy & How To Do It

Perineal massage to prepare for birth

Beside the fear of being in pain, what do you think is the most common fear of a woman who is preparing to give birth? You’re right… Tearing!

I mean… this is a legit fear right!? How is it possible for such a small hole to open as big without bursting? Well, rest assured that hormones help a ton during labor and delivery and this area was designed for childbirth! Remember that, your body was made to grow and birth babies. Besides, women have been giving birth since the beginning of humanity and vaginas have stretch to give birth ever since. 

Your perineum muscles have this special capability of stretching more than you can imagine… 250% of their length the be exact! However, it’s true that tearing can happen.

So, is there anything you can I do to prevent tearing?

What is perineal massage?

Vulva and Perineum muscles - Perineal massage

Vulva and Perineum muscles - Perineal massage

I know it may sound odd, especially if you’ve never taken a close look to your vulva with a mirror or if you aren’t familiar with this body part, but I’m one of those who believe that perineal massage definitely helps prep your tissues for the big day!  

Studies have shown that Women who do perineal massage during the few last weeks of pregnancy are less likely to tear at childbirth.

What is perineal massage?

For those who don’t know, this is a technique you can use near the end of your pregnancy to prepare your perineum for the stretch of childbirth by increasing its elasticity. I’ll describe a step by step with pictures to learn how to massage perineum bellow

I tore A LOT while giving birth to my 1st son. I didn’t prep my perineum, I wasn’t practicing abdominal breathing exercises and I had no idea how to push… I mistakenly thought it would be instinctive! Well, it wasn’t for me and looking back, some birthing classes would have been a great investment… However, my 2nd delivery experience was just perfect! I had taken the time to learn birthing techniques and my husband and I regularly did perineal massage starting at 34 weeks. If your partner isn’t up for it or if you don’t feel like asking him, you can also do it by yourself, but as you gain weight and your belly gets bigger, reaching this area can become challenging!

Honestly, this “massage” feels much more like a perineal stretching than a massage… but I wanted to give myself the best chance to end up with an intact perineum. I know that the fact that it was a second delivery helped a lot, but I wanted to give myself the best chance for a less traumatic delivery!

Thinking of tearing is stressful, but I believe that to overcome your fears, you must confront them. So, if you are afraid of tearing, then “play” with your perineum and learn to stretch and discover this part of your body! Acquaint yourself with the sensations of stretching, heaviness and pressure. Tame these sensations, learn how to breathe and relax though them. This practice can prepare your mind and body for the delivery to come.

When to start perineal massage?

The best time to start perineum massage is around 34 weeks.

There is no harm in doing it (presuming you have checked with your midwife or doctor), and you can’t really “do it wrong”, but I’ll guide you though it!

How to do perineal massage

Perineal massage pregnancy - Oil made by  Weleda

Perineal massage pregnancy - Oil made by Weleda

I know some peoplemay use any kind of edible oil… but I do recommend going with a perineal massage oil -specifically designed for this sensitive area. You don’t want to take the risk to unbalance the vagina flora or pH. I chose an all-natural perineal massage oil made by Weleda and was very happy with it! They recommend to perform the perineal massage right after bathing in warm water, and after making sure your bladder is empty (this detail is very important Ladies!). 

Taking about Weleda, here’s their Step by Step - How to perform perineal massage

“Having washed your hands, find a comfortable, relaxing space. You can do the massage yourself or it can be a way of involving your partner in your pregnancy.

Begin by placing both hands
on your perineum and just relax about touching this part of your body. We can hold a lot of tension around the perineum, and releasing any tension here is good preparation for birth.

Pour a little oil into one hand and rub your hands together to warm them. Then gently smooth a little oil over the whole of your perineum. Stroke in whatever way feels comfortable for you. Get to know the different areas of skin - some soft and delicate, and some firm and more muscular which will stretch out in labor. Massage this a little more firmly. You could apply a little pressure here as you breathe out. 

Try doing your pelvic floor exercises. As you breathe out draw up your pelvic floor and as you breathe in, relax. Make sure that your buttocks are not tightening. Make the exercises harder by tightening the muscles gradually on your out-breath, imagining that you are going up floors in a lift. Go down the floors with the in-breath. Don’t clench your jaw: relaxing your jaw in labor can help relax your perineum. 

You can also do some gentle pulsing, tightening and releasing, as you breathe out. If you feel comfortable, you can try doing these exercises with a finger or thumb inside your vagina. 

In the last few weeks of pregnancy you can try stretching out the perineum to prepare for birth. To do this, place your finger or thumb inside your vagina up to the second knuckle, and gently massage in a rhythmic U shaped movement the lower part of the vaginal opening nearest to the anus (if you imagine a clock face, it’s the section from 3 o’clock to 9 o’clock). This will gently stretch the vaginal tissues and muscles. 

As you feel comfortable you can try increasing the pressure and adding in a stretch back towards the anus. This may sting slightly; this stinging sensation occurs when the baby’s head is born.”

You can read their full article here

Perineal massage - Massage the inside and outside of the perineum

Perineal massage - Massage the inside and outside of the perineum

Perineal massage - Perform rocking motions from the inside out

Perineal massage - Perform rocking motions from the inside out

Perineal massage - Stretch the tissues radially

Perineal massage - Stretch the tissues radially

Perineal massage - Add in a stretch back towards the anus

Perineal massage - Add in a stretch back towards the anus

You can also find a great video from Sophie Kirkham, Hypnobirthing Teacher, explaining the technique here

Tune in!

perineal massage pregnancy

Note that an intact perineum after an unmedicated vaginal birth is not uncommon, and it is not luck either.

If you give birth at your own pace, pushing when you feel like it, your chances of having an intact perineum are higher. That being said, just because you decide to have an epidural doesn’t mean that you’ll automatically tear! 

 

Good luck Mamas! And remember, your body was designed to give birth. Prep yourself and remember to trust your body.

  


Please consult your doctor or midwife if you have any concerns about perineal massage and/or how to do it.

A special thank you to the company Weleda for authorizing me to use an extract of their article and to my friend Alex for her illustrations!


Be sure to read my related articles about:

Sex Positions during Pregnancy,

Pregnancy Diet ,

as well as my Fitness Pregnancy Tips to have a healthy baby and experience!