Allied health care providers agree and studies show that perineal massage a minimum of 1 or 2 times a week – or as often as you like – after 35 weeks of pregnancy can reduce pain during crowning. Regular perineal massage can also reduce the time spent in the second stage of labour, spontaneous tearing and the need for episiotomy in those who have never previously given birth.
Even in cases where perineal tearing does occur, regular perineal massage has been shown to result in first-degree tears more often than second-degree tears (and this is a case where less is good). Studies of over 2,500 birthing people also show a reduction in perineal trauma at birth and a reductinon in pain at 3 months postpartum.
That’s a lot of potential benefit for something that takes only 10-15 minutes a week!
- Warm your perineum with a bath, shower, or warm compress for about 10 minutes to soften tissues and promote elasticity.
- Recline comfortably on your bed or other comfortable surface, propping your back with pillows. You may want to place a towel under you.
- Be sure you are relaxed. Like inserting a tampon or menstrual cup, the procedure will be uncomfortable if your body is tense.
- Ensure your hands are clean and your fingernails are trimmed (or those of your partner/trusted person if someone else is performing the massage).
- Apply a lubricant like Push Perineum/Bottom Balm to your perineum.
- Insert one or both thumbs (if comfortable) into the vagina to the depth of your knuckle. Apply gentle pressure downward – slight burning and stretching is to be expected, but if it hurts, reduce the pressure. Allow the perineum to stretch for about a minute. After this first round of stretching, you may be able to add the second thumb if your perineum was tight in the beginning.
- From the downward position, pull outward as though you are moving your thumbs around the rim of a bowl while moving upward toward the pubis.
- Continue these movements – downward stretching, upward circular gentle pull – for about 5 minutes or as long as is comfortable or desired.
If you are having trouble reaching while reclined, the massage techniques can be performed while standing and propping one leg on a stool or other raised platform (think lunge position or inserting a tampon).
Having a trusted person perform perineal massage can be a wonderful bonding experience.