Why do I need to do a perineal massage? How do I do it?

You probably heard the word perineum a lot during pregnancy and as a midwife we always think everybody know what the perineum is!

I had a lot of women actually asking me where the perineum is and why it is so important to massage it.

So let’s go back to the basis.

First of all where is the perineum? Women think is a silly question and are worried to ask. It is a right question to ask if you don’t know, never be scared to ask a question if you don’t know.

“The perineum is the area between the vagina and the anus. “

I know you might have a bump now and it is difficult to have a look. Therefore, take a mirror (I am sure as a woman you have a little mirror) and have a look where it is. One of the best positions to look at your perineum is sitting on the toilet. I know it is not the most comfortable position but with a bump and restriction of movement sitting on the toilet is quiet handy. Or you can try to sit at the edge of a chair or sofa.

Have you found that little bridge that connects the vagina and the anus? That is your perineum!

Yes you perfectly knew where it was but you didn’t know the name. Why should you?

So now that we know where the perineum is why do we have to massage it before birth?

“Research into perineal massage found that expectant mothers who massage the perineum from approximately 35 weeks of pregnancy, reduce the likelihood of tearing and the need of an episiotomy (when the perineum is surgically cut to help the baby’s delivery).”

So what do we want to achieve with the perineal massage?

We want to softens the tissues and make it more elastic. A soft tissue is more elastic, more flexible and less likely to break.

So let’s help your perineum to get more elastic and hopefully reduce the risk of tear. How and how often do you do it?

How To do a Perineal Massage:

  • First of all wash your hand and sit or lie back in a private, warm and comfortable place (as previously said the toilet could be an easier place).

  • Apply a lubricant such as olive oil or sweet almond oil (or any neutral oil) to your hand and the perineal area. (if you are subject to thrush be careful on what you are using and try to avoid any perfume solutions inside your vagina).

  • Place both thumbs about 3cm into your vagina. (it might be difficult to do both together so you can do one side at the time)

  • Massage the area by gently rubbing the perineal tissues between your thumbs and fingers.

  • Press downward and to the sides, gently stretching until you fell a tingling sensation.

  • Once this sensation is felt, hold the stretch for around one minute, until the feeling subsides, and begin gently massaging the lower part of the vagina by moving your thumbs back and forth. While massaging also hook your thumbs on the sided of the vagina and gently pull the tissue forwards, as your baby head does when it is being born.

  • Continue to gently rub as you stretch, for around 3-4 minutes.

If you only read how to do it looks very complicated but it is not. Take the instructions with you and follow them step by step. The first time you will think it is very difficult, the second time it will get bit easier and if you do it daily, at some point you will not need the instructions anymore. As everything it takes time to learn and with daily practice it will become more natural. It is also a great way to learn a little bit more about your body and your vagina. So don’t be scared. Think that your perineum needs a nice massage/treat like your hands or feet.

By massaging the perineum once a day, you will noticed the area becoming more flexible and you will become more used to feeling the stretching sensation that occur during birth.

So what are you waiting for? Go and practice your perineal massage!

midwife explaining how to do a perineal massage