Perineal massage

What is perineal massage?

Your perineum is the area between your vaginal opening and the rectum. This area stretches a lot during childbirth and sometimes tears. Perineal massage in pregnancy aims to gradually soften and stretch the vagina and area around it in preparation for birth. This leaflet explains why this is important and gives instructions on how you or your partner can carry out this exercise.

What are the benefits of perineal massage?

Research studies have found that perineal massage during the last weeks of pregnancy can reduce the chance of your vagina tearing and also reduce the need for forceps or ventouse suction to help you birth your baby. It is particularly beneficial for women having their first baby, women over 30 years old and women who have had episiotomies before. It will help you to become familiar with the feeling of pressure or stretching of the perineum that you will feel when your baby is being born.

Your midwife can discuss perineal massage, its benefits and how to do it. They will also answer any questions you may have. This leaflet is a reminder of how to do perineal massage for when you get home.

How do I do perineal massage?

Perineal massage should be done three or four times a week for five minutes, beginning six weeks before your baby is due.

Either you or your partner can do the massage. Use a mirror for the first few times so you can see what you are doing. It is more comfortable to do the massage after a bath as this will soften the surrounding tissues.

Before starting, go to the toilet if you need to, wash your hands and find a comfortable position: sitting, lying down supported by pillows, squatting against a wall or standing with one foot raised and resting on the bath, toilet or a chair.

  1. Use a lubricant such as vitamin E oil, almond oil or any vegetable oil such as olive oil. You may also use a water-soluble jelly such as K-Y Jelly. Do not use baby oil, mineral oil or petroleum jelly (Vaseline). This lubricant will help your fingers move smoothly over the perineum and lower vaginal wall.
  2. If you are doing the massage yourself, it is probably easiest to use your thumbs. Your partner can use both index fingers.
  3. Place the fingers or thumbs about two inches (five centimetres) into the vagina (up to your second knuckle).
  4. Using a sweeping motion, pressing downwards, move in a rhythmic movement from right to left and back again, as shown in the diagram. This movement will stretch the vaginal tissue and muscles surrounding the vagina.
  5. You can also massage the skin of the perineum between the thumb and forefingers.
  6. As you or your partner perform the massage, apply steady pressure downwards towards your bottom until you feel a tingling sensation. This will help you recognise the feeling that you will have when your baby’s head begins to come out of your vagina (crowning).
  7. Use more oil if you need to reduce friction and make the massage more comfortable.
  8. Concentrate on relaxing your pelvic floor muscles during the massage.

It takes time

With time and practice the tissues will relax and stretch. This massage should not be painful and should you find it so please ask your midwife for more advice.
If you do find the massage painful, frightening or distressing, please talk to your midwife or doctor. Some women have had operations or painful or difficult experiences. By letting your Midwife know they can plan your care more effectively in labour.

Written by the fantastic midwives at Brighton and Sussex University Hospitals Trust. Read more at www.mypregnancymatters.org.uk