Perineal Massage - Where to start!

When we talk about Perineal massage it always evokes a range of reactions! Some ladies want to know every detail whilst some are totally shell shocked. Below are some of the comments I have had recently, hopefully we can chat through some of these topics now 😊 SO grab a cuppa and let’s talk all about the perineum!!!!!!

“I will do ANYTHING to limit the chance of me tearing!”

“I just don't like the thought of touching down there!”

“I have never even looked down there”

“My husband will do it for me”

“I will never let my husband do that!!!!”

“I don't know where I am meant to be pressing!?!?”

However you feel about perineal massage it is important to trust your own beliefs and emotions prior to starting the technique. It is not going to be something that’s for everyone. It’s important you understand the technique and the benefits and then you can make a choice that’s right for you.

What is Perineal Massage?

Perineal Massage is a technique to stretch the perineum to prepare it for the stretch it undergoes during labour and birth. The Perineum is the area of skin between the vagina and the anus and is the part that may tear or be cut (episiotomy) during labour. The idea is that slowly stretching this area before we give birth may prevent trauma of the perineum.

Benefits -

1) Perineal stretches when done regularly can help to gradually stretch the skin and pelvic floor muscles in preparation for the stretch of the perineum during birth.

2) Many ladies have never looked, felt – or even know where the perineum is. By having the opportunity to regularly look and feel the area it can help improve your body awareness and giving you time to get acquainted with the area for birthing.

3) Having the opportunity to regularly feel what a perineal stretch feels like will give you some experience to draw upon during labour. Having better awareness – or proprioception as we call it – may make it easier for you to allow the pelvic floor to stretch and relax during pregnancy. Most pelvic floors tighten up and clench in moments of stress and pain so it’s useful to practice your breathing techniques with this stretch applied in a controlled environment prior to labour.

Risks -

It is best to get advice from your midwife and/or consultant if you are a high risk pregnancy – for example…

Vaginal Bleeding

History of preterm birth

Incompetent cervix

Active infection

Vaginal thrush

Urinary tract infection

Genital herpes

The Evidence

A Cochrane review of four trials (2497 women) showed that perineal massage undertaken by the woman or her partner was associated with an overall reduction perineal stitches and episiotomy.

These findings were significant for women who had given birth vaginally before but was less clear for those who had. There was unfortunately no statistical difference when looking at the incidence of third and fourth degree tears. (Beckmann, Stock 2013)

How do you do it?

When to start