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Preparing for Birth: Perineal Massage

© Maurenne Griese

When women give birth, especially for the first time, many experience tears in the perineum, the area between the vagina and the anus. Massaging this area during the last few weeks of pregnancy may reduce the risk of perineal injury. Prenatal perineal message is a technique which slowly and gently stretches the skin and tissues around the vagina and perineum. Perineal message helps reduce the risk of tearing during birth and the need for and episiotomy.

A 1999 study by Canadian researchers supported the belief that perineal massage performed during the last few weeks of pregnancy appeared to be effective in preventing perineal tears. Among these 1,034 women in the study, the rate of giving birth without tearing the perineum was 61 percent higher in those who had performed the massages beginning in the thirty-fourth or thirty-fifth week of pregnancy than in women who did not massage themselves.

A 1997 study by British researchers reported that perineal massage reduced the risk of instrumental births (forceps or vacuum assited births), particularly in women over 30 years of age. They also reported that perineal massage decreased the incidence of second and third degree perineal tears and episiotomies.

Directions:

Wash your hands.

Find a private, comfortable place and sit or lean back in a comfortable position.

Put a lubricant such as KY jelly, cocoa butter, vitamin E oil or pure vegetable oil on your thumbs and around the perineum.

Place your thumbs about 1-11/2 inches (3-4 cm) inside your vagina. Press downwards and to the sides at the same time. Gently and firmly keep stretching until you feel a slight burning, tingling or stinging sensation.

Hold the pressure steady at that point with your thumbs for about 2 minutes or until the area becomes a little numb and you don't feel the tingling as much. Keep pressing with your thumbs. Slowly and gently massage back and forth over the lower half of your vagina, working the lubricant into the tissues. Keep this up for 3-4 minutes. Remember to avoid the urinary opening.

As you massage, pull gently outwards (forwards) on the lower part of the vagina with your thumbs hooked inside. This helps stretch the skin as the baby's head will stretch it during birth.

Do this massage once a day, starting around the 34th week of pregnancy. After about a week you should notice an increase in flexibility and stretchiness. If you are uncomfortable about doing this yourself, you may want to ask your partner for assitance. Be sure that you provide your partner with feedback about what is comfortable.

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