Perineum Massage

Perineum massage is the gentle stretching and massaging of the perineum (skin between the anus and vagina) during the last weeks of pregnancy (after 34 weeks).

Benefits of Perineal Massage

• Perineum becomes more supple and elastic reducing the possibility of perineal tearing or an episiotomy.
• Prepares you for the feelings of pressure and stretching when your baby’s head starts to crown.
• It helps you understand what muscles you are using for birth so that you can relax these muscles easily during the actual delivery.

An article in the American Journal of O&G (Labrecque et al, 1999) that evaluated the effectiveness of perineal massage during pregnancy for the prevention of perineal trauma at birth.

• Women with first vaginal birth, 25% of women who used perineal massage and 15% of women who did not use perineal massage were delivered vaginally with an intact perineum.
• Women with a previous vaginal birth, 35% of women who used perineal massage and 32% of women who did not use perineal massage were delivered vaginally with an intact perineum.

The authors concluded that perineal massage is an effective approach to increasing the chance of delivery with an intact perineum for women with a first vaginal delivery, but not for women with a previous vaginal birth.

Slow controlled delivery is the key to an intact perineum and reduced incidence of laceration. The mother and partner must listen closely to the care provider for advice on when to push and when to stop pushing.

Technique for Perineum Message:

Can be performed by the mother or a partner

• Wash your hands thoroughly and trim nails to remove sharp edges.
• Apply the lubricant of your choice to the perineum (olive oil, KY jelly, sweet almond oil, vitamin E, etc)
• Place the thumbs into the base of the vagina up to the first joint, making sure they are well lubricated
• Using gentle but firm pressure, move the thumbs from the base of the vagina up the side walls as if you were making a “U”, but remembering to avoid the urethra
• As you feel a tingle or stretching, hold the position until it subsides and then continue upward
• Return the thumbs to the base of the vagina, and repeat

Remember to go slowly and be gentle. If you are too rough, you can cause irritation or infection

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