Perineal Massage
Perineal massage is a hot topic. People say it reduces your risk of tearing during vaginal birth, so OF COURSE it's a hot topic. Research is mixed on whether or not it actually prevents tearing. (If you want to know more, you can read about it HERE). We will tell you from anecdotal experience working with pregnant and birthing people as pelvic floor therapists & birth doulas, we DO see great benefits of perineal massage. And there aren't any risks… so why not give it a try?
What Is Perineal Massage?
Perineal massage is the manipulation of perineal tissue in preparation for vaginal birth. Your perineum is the tissue located between your vagina and anus. This is the area that requires the most stretch during a vaginal birth.
Does Perineal Massage Really Help With Labor Pain & Delivery?
The benefits we see may not necessarily be from stretching the tissue, but from practicing a lengthening, relaxing breath to the pelvic floor and YIELDING to that discomfort. Our natural response to pain is to tense. Our goal is to keep these pelvic floor muscles relaxed and open in order to allow a baby to pass through. This is easier said than done, and like most things in labor/birth, we definitely recommend practicing during pregnancy.
How To Do It
The goal is to find a position where you can be as relaxed as possible and still reach your perineum (we know this is challenging when your belly’s in the way!) Some people prefer to have their partner help. Once you find the right position, get some oil or lube on your thumb and first finger. Insert your thumb in your vagina up to your first knuckle and apply slight pressure downward (towards your anus). The pressure should be slightly uncomfortable and stretching, but not painful. You will then move your thumb in a u-shaped, sweeping motion from side to side, maintaining that pressure. The goal throughout this time is to inhale into your pelvic floor, and feel your muscles and tissues stretch, relax, and open. On your exhale, keep everything relaxed.
We recommend most people start around 35 weeks and complete massage for 3-5 minutes, 2-3 times a week. And focus on that breath! Check out this video for more guidance:
Benefits Of Perineal Massage
As I mentioned above, I really like the practice of perineal massage for mindfulness, breathwork, and practice tuning into and relaxing the pelvic floor. This is also a great time to speak positive affirmations to yourself and visualize your birth. Mindset plays a huge role in labor & birth. Learning how to let go, surrender, and open yourself up to the process of labor can be really challenging, and we recommend starting that practice during pregnancy!
Is This Something To Continue After Giving Birth?
If you give birth vaginally and have any kind of tearing to your perineal tissue, we highly recommend completing scar massage once your tissue has healed (generally around 6 weeks). Scar massage is different from perineal massage, so we suggest working with a pelvic floor therapist who can guide you through the techniques that are best for you.
Final Thoughts On Perineal Massage
Evidence is mixed on whether or not perineal massage actually reduces your risk of tearing during a vaginal birth, but there aren’t any risks, so we say go for it! As always, an individualized plan created by a pelvic floor therapist is the best option for most people. If you’re looking for prenatal therapy and birth prep, give us a call!
Written by: Dr. Courtney Trocinski