From the moment you discover you’re pregnant, a flood of (often unsolicited) advice comes your way about how to prepare your body for the arrival of your little one. The challenge of pregnancy is that it is ever-evolving; you can’t simply tell people after your first trimester that you are done with advice. They will inevitably say, “Oh, but you have no idea what awaits you in the second trimester.” Spoiler alert: this cycle continues until your child heads off to college.
Of course, whether you choose to follow much of this advice is a matter of personal preference and varies significantly among pregnant individuals. However, if someone brings up perineal massage, it’s definitely worth paying attention to. Here’s what you need to know about perineal massage, including how to perform it and the best oils to use.
What Happens to the Perineum During Childbirth?
Let’s delve into the perineum. If you’re not familiar with it (don’t worry, you soon will be), it’s the area located between the vagina and the anus or between the scrotum and the anus. This part is universal, regardless of anatomy, and plays a crucial role in supporting the pelvic floor, which helps keep your reproductive organs, bowels, and bladder in position.
Usually, the perineum doesn’t see much action, except for those rare moments when things go awry. However, during childbirth, the situation changes dramatically. If you’re having a vaginal delivery, there’s a good chance your perineum may not remain intact. Although it attempts to stretch to accommodate the baby’s head, it can sometimes tear. Not all tears are created equal, though; some only involve the skin around the vagina, while others can extend to the anal sphincter (these are known as third- and fourth-degree tears). This leads us to the episiotomy, a procedure where the perineum is cut to facilitate the baby’s entry through the birth canal—though these are less common now than they once were.
If this sounds uncomfortable, it is. To help make vaginal delivery smoother, some healthcare professionals might recommend perineal massage during the later stages of pregnancy. Here’s how you can do it.
How to Perform a Perineal Massage During Pregnancy
If you’ve never massaged the area between your anus and vaginal opening, you might need some guidance. Even if you have prior experience, having a baby on board makes things a bit different. Essentially, perineal massage involves stretching and manipulating the perineal tissue with one or two fingers—typically your own or those of a partner or dedicated friend. The goal is to prepare the tissue for childbirth by stretching it, with the hope that it will stretch rather than tear during delivery. If tearing does occur, the idea is that it will be less severe.
A quick note: While this is termed a “massage,” it may feel uncomfortable or even burn at first, but you will likely adjust over time. Here’s a simple guide to performing perineal massage:
- Sit with your legs spread apart and back supported. If you’re doing it yourself, having a hand mirror can help you see what you’re doing.
- It’s essential that anyone involved washes their hands thoroughly before starting.
- Use a lubricant on your fingers. (We’ll discuss options shortly.)
- Insert a thumb or finger about two inches into your vagina and gently stretch the wall outward to the side, which you can think of as 3 o’clock.
- While maintaining pressure, sweep downward to 6 o’clock and then over to 9 o’clock.
- Repeat this process for about 4 to 5 minutes.
When to Start Perineal Massage
According to recommendations from health experts, you should begin perineal massage around 34 weeks into your pregnancy, performing it three to four times a week for about five minutes each session. This is a minimal time commitment compared to the potential healing time required if you experience a perineal tear or episiotomy.
What Oils to Use for Perineal Massage
Using some type of lubricant reduces friction and enhances comfort during the massage. You can opt for a water-soluble lube like K-Y Jelly or Astroglide, or you might prefer a lubricant you are already comfortable with to avoid any allergic reactions. Natural oils such as organic sunflower, grapeseed, coconut, almond, olive, or vitamin E oil are also excellent options. Just steer clear of synthetic oils or lubricants, like baby oil or petroleum jelly.
A Bit of Humor to Lighten the Mood
Feeling anxious about the idea of perineal massage is completely normal. Pregnancy and childbirth can push you well outside your comfort zone. To ease the tension, why not enjoy a good laugh? Check out this amusing scene about perineal massage from the movie Baby Mama.
For further reading and insights, take a look at this other blog post we’ve created here, or visit Make a Mom, an authority on this topic. Additionally, for valuable information on pregnancy and home insemination, check out this resource.
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In summary, perineal massage can be an effective technique to prepare your body for childbirth, potentially reducing the risk of more severe tearing during delivery. Starting around 34 weeks into your pregnancy and incorporating it into your routine can help ease the birthing process.
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