How Perineal Massage Can Reduce Your Risk of Tearing By 64%!
What is the perineum?
Your perineum is the space between your vagina and anus. During vaginal delivery, the perineum undergoes significant stretch and focal pressure as baby begins to crown. This area gets significantly stretched with a vaginal birth and is where you can generally tear.
Why do you massage the perineum?
We have evidence to show that by massaging and stretching the perineal muscles, you can significantly improve your birth outcome.
- Reduces your risk of 3rd and 4th degree tears by 64%.
- Reduces your risk of episiotomy by 21%
- Reduces risk of anal incontinence by 70%.
- Reduces the duration of 2nd stage labour (active pushing) by approximately 6 minutes.
- Significantly reduces postpartum perineal pain.
When do you start doing this?
It is recommended to begin this around 34 weeks gestation. This is routinely discussed and taught during our birth preparation appointments in-clinic. We also go through pelvic floor down-training so ensure your pelvic floor muscles are as flexible and relaxed as possible in the lead up to labour and birth.
How do you do it?
- Wash your hands thoroughly
- Apply lubricant on your fingers
- Insert 1 finger or your thumb into the vagina about 2-4cm
- When you’re ready, aim to have 2 fingers inside the vagina providing a bilateral stretch down and outwards in opposite directions until you feel a slight sting or burn.
- FIND THE RIGHT PRESSURE:
- Breathe in, applying a downward pressure towards your anus with your index finger/s.
- As you exhale, hold this pressure.
- Continue to hold this pressure for up to 10 seconds, breathing deep into the belly as you do so. Release the pressure.
- Repeat this movement, increasing the hold pressure as your tolerance permits.
- THE SWEEP:
- Breathe in, and apply the same downward pressure as before.
- As you exhale, maintain pressure and sweep the fingers away from each other, then back to each other continuously in a ‘U’ shape.
- Repeat this movement, working at increasing the stretch as you go.
This will feel a little uncomfortable because you are literally stretching the muscles and the skin. But also work within the range that you can handle and always be guided by your Women’s Health Physio.
Your partner can get involved and help out as well as this can be a little tricky when you’re so far along in your pregnancy.
We always recommend seeing a Women’s Health Physio before trying this at home so we can educate you how to do it to suit your body. We will run through this with all clients during their 34-week birth prep assessment.
Please book an appointment to see us using the ‘Book’ link.
Disclaimer:
This is general information only. Please ONLY do this once you have been guided by a Women’s Health Physiotherapist.
References:
Okeahialam, N. A., Sultan, A. H., & Thakar, R. (2023). The prevention of perineal trauma during vaginal birth. American Journal of Obstetrics and Gynecology, 230(3). https://doi.org/10.1016/j.ajog.2022.06.021