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Perineal massage

Just the thought of an episiotomy can bring tears to most peoples' eyes so it's not all that surprising that most women are keen to avoid tears, cuts and stitches during birth.

So, can perineal massage during the last few weeks of your pregnancy, help you to avoid perineal trauma?

Perineal massage is a technique which increases the elasticity of the perineum for birth, by encouraging blood flow to the area. The perineum is the area of skin between your vagina and rectum which can be cut in an episiotomy or can tear during delivery

Perineal massage has been found to reduce the need for stitches, and it leads to fewer women reporting pain 3 months after the birth.

Benefits of Perineal Massage

Bullet It stimulates the blood supply to the perineum and helps speed the healing process after the birth
Bullet It helps prepare you for the feeling of pressure and stretching that comes as your baby's head is born
Bullet It helps to familiarise you with some of the sensations such as tingling or burning so you are less likely to tense up
Bullet It can help you to relax when you have a vaginal examination

Midwife Tania Pearce has noticed that women who have done perineal massage are more likely to have perineums that stretch well around the baby's head. "These women also have more control over the expulsion of the baby's head, and allow it to be born slowly. Because they are use to the sensations they are experiencing they are not frightened of them and don't rush the birth. She said: "During the birth, women are not frightened of the crowning head sensation, post birth they are less likely to tear and long term they are less likely to experience pain, thus having a positive impact on a woman's birth experience as well as subsequent births."

It's important to note that Perineal Massage should be avoided if you are suffering from herpes, thrush or any other vaginal infection as massage could spread the infection and worsen the condition.

Tania recommends starting perineal massage about 4 to 6 weeks before your due date...

She suggests that you...
Bullet Wash your hands and find a comfy place and sit or lean back using cushions to support your legs.
Bullet Use an unscented vegetable oil, such as sunflower oil or olive oil on your thumbs and around the perineum.
Bullet Place one or two thumbs or fingers about 1 inch (2-3cms) 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.
Bullet Hold the pressure steady at that point with your thumbs for about 2 minutes until the area becomes a little numb and you don't feel the tingling as much.
Bullet Keep pressing with your thumbs. Slowly and gently massage back and forth over the lower half of your vagina. Do this for 3-4 minutes. Remember to avoid the urinary opening. You can start with very gentle massage, increasing the pressure as sensitivity is reduced.
Bullet As you massage, pull gently outwards (forwards) on the lower part of the vagina with your thumb(s) hooked inside. This helps stretch the skin as the baby's head will stretch it during birth.

Some partners may like to perform the massage, especially as you near your due date and become less mobile. If the thought of vegetable oil doesn't appeal, you can also use Vitamin E oil, coconut oil or any of the specially prepared perineal massage oils that are now available.

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