Perineal Massage
Trauma to the perineum during birth can be in the form of a spontaneous perineal tear or an episiotomy. The chance of having a perineal tear range from 30-85% and is more common in a woman having her first baby. Furthermore, women over the age of 35 are 4.36% more likely to have perineal trauma than younger women. Other risk factors for perineal trauma include maternal obesity, macrosomia (baby over 4.5kg), baby in a malpresentation (unusual position) or malposition (such as posterior position) and instrumental vaginal births.
What is perineal massage?
Perineal massage involves stretching the vaginal tissues towards the end of pregnancy to relax and improve circulation to the tissues, increase elasticity and desensitise women to the burning sensation and pain during labour and enabling easier pushing for the woman. Therefore, reducing trauma to the perineum and vagina and decreasing the episiotomy rate in women having their first baby.
Why is it important to reduce perineal trauma?
Perineal trauma can cause significant short- and long-term effects on a postpartum mother.
Short term impacts of perineal trauma include:
Postpartum pain
Increased pain relief requirements postpartum
Pain on urination
Pain with sexual intercourse
Long term impacts of perineal trauma include:
Pelvic floor dysfunctions such as pelvic organ prolapse, urinary incontinence, flatus incontinence and faecal incontinence
Birth trauma
Increased rates of caesarean births in subsequent births
Therefore, reduction in perineal trauma can have significant benefits for postpartum woman’s mental and physical health and thus their ability to bond with their baby.
When to commence perineal massage?
For perineal massage to be effective in reducing perineal trauma it needs to be commenced from the 34th week of pregnancy. Perineal massage is performed either by the woman or her partner for a minimum of 4 minutes 3-4 times a week.
How to perform perineal massage?
Empty your bladder and wash your hands.
Find a relaxing place to sit comfortably, a mirror can help you see what you’re doing.
Have a warm bath or use a BodyICE Woman Perineum Strip as a warm compress on the perineum for 10-15 minutes before you begin.
Put a generous amount of lubricant like natural oil (olive oil or coconut oil) on your thumbs and perineum.
Place your thumbs inside the vagina (approx. 3-5cm in). Gently press downward towards the rectum and sides of the vagina to stretch the opening. You should feel a very light burning sensation.
Place your thumbs together and very slowly and gently sweep the perineum in a ‘U’ shaped motion away from each other at the sides of the vagina.
As you perform the massage, try to focus on relaxing your pelvic floor muscles and deeply breathing.
Relax and repeat.
It is important that you only feel a slight burning or tingling sensation, you do not want to press too hard as it may cause bruising and swelling. Avoid putting pressure at the top of the vaginal opening. If you have any concerns, always speak to your healthcare provider prior to undertaking perineal massage.
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