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Perineal massage explained

Dr. Elizabeth Stroot answers all of your questions

Author Dr. Elizabeth Stroot, PT, DPT
Categories   Third Trimester

The Edit

Studies show 85% of women who have a vaginal birth will experience some form of trauma to their perineum. This may sound like a scary statistic, but trying techniques such as perineal massage during pregnancy can prove helpful in reducing this risk. Lansinoh’s Dr Elizabeth Stroot explains all.

What is perineal massage?

Perineal massage involves massaging the tissue of your perineum – the space in between the vaginal opening and the anus. This is a small area of soft tissue that really is an integral part of the labour and delivery process. Massaging the perineum helps to increase blood flow to the perineal area, which can help the tissues stretch more easily during childbirth.

When should I start perineal massage?

You can begin perineal massage any time after week 34 of pregnancy as by this point in your pregnancy, your relaxin hormone has started to kick in. Relaxin does exactly what it sounds like, allowing your connective tissue to become more extensible so that the skeletal frame has a little bit of play to it as baby starts their journey into the birth canal. Specifically, it's helping to relax the ligaments and pubic symphysis of the pelvis.

What are the benefits of perineal massage?

Massaging your perineum during those last few weeks of pregnancy may help to allow it stretch more easily when your baby’s head is crowning when giving birth. Practicing perineal massage can also help you become more familiar with the feeling of stretching that you will feel during labour.

Studies show that 85% of women who have a vaginal birth will experience some form of trauma to their perineum. That could be in the form of excessive stretching, general swelling, bruising, graze tearing, tearing naturally or an episiotomy, which is a cut in the area between the vagina and anus to enable the delivery of your baby. This may sound like a scary statistic but trying techniques such as perineal massage during pregnancy can prove helpful in reducing this risk.

How do I do perineal massage?

It’s normal to feel awkward, given that this is a technique that perhaps you've never done before, but like anything new it just takes time, patience, and your continued persistence in trying and relaxing into it.

Before getting started, make sure your hands are clean and your nails are cut short. Next, make yourself comfortable and raise one leg (this can be on a stool, sitting, or lying down). Choose an oil formulated specifically for this sensitive area such as Lansinoh’s Organic Pre-Birth Preparation Oil – this will help condition the external skin of the perineum as well as allowing you to easily massage the area.

1. Make small, circular movements on either side of your vulva, to warm the tissue.
2. Put your thumb or finger about an inch into your vagina. Gently stretch the tissue at the vaginal entrance, holding it between your thumb and index finger.
3. Massage from the 6 o’clock to 3 o’clock position, then from the 6 o’clock to 9 o’clock position. Focus on the area at the entrance to the vagina. Take your time and repeat each side 3-4 times. Be gentle but firm enough to work into the tissue.
4. Finish with gentle outwards stretches at the 5 o'clock and 7 o'clock positions, holding for 30-45 seconds. Also stretch any scar tissue you may have from previous births.

Illustrated directions can be found here. You can see the benefits from practicing the technique 5 to 10 minutes a day, even 3 days a week.

During pregnancy, it's important to consult your doctor or midwife before beginning any new activity, including perineal massage. A mild prickling sensation is common, however if you experience any sharp or severe pain or bleeding, stop immediately and speak to your healthcare professional for further advice.

Author Dr. Elizabeth Stroot, PT, DPT

Dr. Elizabeth Stroot is an experienced physical therapist, speaker, and executive coach from the Washington DC area. Her boutique private practice specialises in integrative treatment of women’s health, chronic pain, and complex musculoskeletal conditions. Dr. Stroot is part of the Lansinoh Advisory Network, along with other practitioners who share a commitment to helping women and babies have access to products, solutions, education and support during pregnancy and beyond.

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