The perineum is the thin skin located between the vagina and the anus. Perineal massage technique is used to prepare the skin of the perineum by stretching the tissue and the surrounding tissues around the vagina to decrease the severity of tearing and stinging that may occur during the crowning stage. This technique also helps the expecting mum to familiarise herself with the stretching sensations that are to be expected during birth. At first, during the technique you may feel a strong burning or stretching sensation, however over time the tissues get used to this massage and you may notice a change and the unpleasant feeling decreases due to the tissues becoming flexible and stretchy. Practice this daily for at least 10 minutes a day is advised from 34 to 35 weeks of the pregnancy. However, in saying this, women can still have some benefit if they choose to start later. Research studies not only indicate perianal massage reduce the likelihood of perineal trauma and ongoing postpartum perineal pain and infection, but it also reduces the likelihood of having an episiotomy. And therefore, hopefully increasing recovery time and allowing you to feel more comfortable in your body following the birth. Allowing you to focus on bonding and caring for your new little one.
Getting started with perineal massage
Before you start this massage empty your bladder and wash your hands. If your partner is going to assist, make sure he/she washes their hands to. Some women find a warm bath or warm compress on the perineum beforehand may help relax the area. If you are doing this by yourself, a mirror can be handy to help familiarise yourself with the area. Using an organic unscented oil such as Vit E cream, olive oil or almond oil as a lubricant, and place your thumbs about 3-4cm in depth inside the vagina and press downwards to the anus. Then sweep up the sides of the vagina wall to make a U shape. You will probably feel a tingle or burning sensation when you do this and eventually it may become a numb feeling. Hold the stretch for about 45 sec to 1 min and then release. Apply more oil and repeat for about 10min. If your partner is helping you, it is important to give feedback on how much pressure you can tolerate. Make sure you focus on relaxing your breath and the relax the pelvic floor muscle to allow the tissue to stretch.
Do not do this technique if you are before 34 weeks, have a low-lying placenta, any active vaginal infections that you could spread to other areas such as herpes or thrush. Or if your partner is helping you, that they do not have any infection or open wound on their fingers or hands.
In this research article: Antenatal perineal massage for reducing perineal trauma, researchers investigated four RCTs that included women preforming perineal massage with in the last four weeks of pregnancy (2497 women). Findings include significant reduction in the need of suturing (closing of the wound) for women who have not given vaginal birth before.
https://pubmed.ncbi.nlm.nih.gov/23633325/
In this research article: Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta-analysis of randomized controlled trials. Looked at 11 RCTs with 3467 women, found that antenatal perineal massage significantly decreased the incidence of episiotomies and perineal tears, particularly the risk or third and fourth-degree perineal tears. They also found improvement in wound healing, perineal pain was less, second stage labour duration was less, and anal incontinence had significant improvement.
https://pubmed.ncbi.nlm.nih.gov/32399905/