What Is Perineal Massage?

If you are expecting, you have probably read about or heard about the perineum in one of those what-to-expect-when-expecting books. If you haven’t heard of it before, welcome to my class. The perineum is the area of tissue between your vagina and your anus.

It’s super important by the way, being connected to all the muscles in your pelvic floor. These muscles support your reproductive organs, bowels and bladder.

When counting down the days to counting your little one’s tiny fingers and toes, you need to be preparing your body too for the birth. Lamaze classes do cover some parts of that but perineal massages are more than just extra credit when it comes to preventing tears during delivery. Let’s talk about that for a second;

Tears in Childbirth

I don’t know if you have watched any birthing videos or a breakdown of what happened but I’ll tell you what happens regardless.

For a normal delivery, vaginal delivery, all the muscles in your pelvic floor work together to stretch and contract allowing the baby to pass through the birth canal. As the baby’s head crowns, your muscles stretch far enough to push its shoulders and body through. This is where tears occur. The goal of a perineal massage is to minimize pain and reduce your chances of tearing at this stage of the delivery.

A study conducted showed that roughly 90% of women do experience some tearing during their first normal delivery, which is an overwhelming figure without a doubt. It may help to mention that the majority of the tears in these cases are only superficial. What I mean by superficial is that they only affect perineal skin and the outer layer of your vagina so you should heal just fine.

Experts categorize these tears by degree of severity;

First Degree Tears

These tend to be the most common and they impact the skin on the surface of your perinium – closest to the vaginal opening. They do heal on their own but may sometimes require suturing.

Second Degree Tears

Second degree tears tend to go deeper than the surface of the skin on your vagina and into the perineal muscles but not the anal muscles. Owing to them going deeper than the surface of the skin, they may require stitches.

Third Degree Tears 

Third degree tears are like second degree tears bar the fact that they also affect the muscles around your anus. They also require stitching.

Fourth Degree Tears

Fourth degree tears are the most severe of the lot. They impact your perineum, anus and rectum. As such, they come with a longer recovery time. They however only happen in less than 1% of cases.

Tips and Techniques on How to Do Perineal Massage

After knowing what is perineal massage what follows is how to actually do it. Before getting started, consult your healthcare professional to determine the appropriate frequency of perineal massage for you.  Regardless of how often you do it, 5-minute sessions are enough to reap potential benefits. The sessions should start 4-6 weeks before delivery.

You really don’t need much to get started. All you need is a clean pair of hands, I believe you can take care of that, and perineum massage oil. You may use a variety of oils for the massage. The main goal of perineum massage oil is lubrication to eliminate friction.

Choosing what lubricant to get is a matter of personal preference, access and budget. You could use natural oils like coconut oil or use personal lubricants that are water soluble. PS: steer clear of synthetic oils or lubricants like baby oil or petroleum jelly.

How to Perform a Perineal Massage

Begin by washing your hands and trimming your nails so you don’t poke yourself. Set yourself up in a comfortable position in a private space. You could lie down with your legs wide open and knees bent. If you’d like to sit upright, use a pillow to support your torso.

Apply the perineum massage oil to your now clean hands and begin by placing one or both thumbs 2.5-4cm inside your vagina. Press your thumbs along the back wall of your vagina towards the anus and apply some pressure. Hold for 1-2 minutes.

Continue moving your thumbs inward and outward in a slow ‘U’ shaped motion. Increase or decrease pressure depending on what sensation you are feeling. A slight burning sensation is the goal.

Keep your breathing deep and slow to keep your body and mind relaxed through the entire massage.