Perineal Massage - A How To Guide

 

 

What is Perineal Massage?
Perineal massage is a technique that helps stretch and prepare the perineum (the area between the vagina and anus) for childbirth. It can reduce the risk of tearing, episiotomies, and pelvic floor trauma during delivery.

Starting at around 34–36 weeks of pregnancy, you can perform perineal massage either on your own, with a partner, or using a pelvic floor wand.

Benefits of Perineal Massage

• Improves the flexibility and elasticity of the perineal tissues
• Reduces the likelihood of perineal tears or episiotomy
• Helps you become familiar with the sensation of stretching, which can make pushing during labor more manageable

General Guidelines

1. Choose a Comfortable Position:

   • Semi-reclined with knees bent and legs apart
   • Standing with one leg propped up
   • Side-lying if you’re more comfortable

2. Prepare the Area:

   • Wash your hands thoroughly.
   • Use BIEN water-based intimate gel or your preference of lubricant/gel 

3. Relax:

   • Breathe deeply to relax your pelvic floor muscles.
   • A warm compress on the perineal area for 5–10 minutes beforehand can help.

Option 1: Performing Perineal Massage with a Partner

1. Positioning:

   • Sit comfortably or lie back with support.
   • Your partner should sit or lay in a position that allows easy access to the perineum.

2. Technique:

   • Your partner should apply a small amount of lubricant to their thumbs.
   • Insert their thumbs about 2–3 cm into your vaginal opening.
   • Press down gently towards the anus and to the sides (like the shape of a “U”).
   • Maintain firm but comfortable pressure, avoiding pain.

3. Stretching Motion:

   • Use slow, sweeping motions to stretch the tissues.
   • Hold the stretch for 1–2 minutes where there’s tension.
   • Continue for 5–10 minutes, 2–3 times per week.

4. Communication is Key:

   • Let your partner know if the pressure feels too strong or uncomfortable.
   • Work together to ensure it feels beneficial.

Option 2: Using a Pelvic Floor Wand

1. Orientate yourself to the Pelvic Floor Wand:

   • Using the flat end of our Pelvic Floor Wand, place Water-Based Intimate Gel generously on the tip and about 5 cm up the neck of the wand
   • Ensure to clean thoroughly before use.

2. Positioning:

   • Sit on the edge of a chair, stand with one leg propped, or lie on your back with pillows behind your back

3. Technique:

   • Insert the curved end about 2–3 cm into the vaginal opening.
   • Gently press the wand downward (towards the anus) and to each side in a sweeping “U” motion.

4. Stretching and Breathing:

   • Hold gentle pressure at areas of tension for 1–2 minutes.
   • Breathe deeply and focus on relaxing your pelvic floor muscles.

5. Duration and Frequency:

   • Perform for 5–10 minutes, 2–3 times per week.

Tips for Success

• Start gently and gradually increase pressure as your comfort allows.
• Avoid pressing directly on the urethra or too forcefully.
• Use a mirror if it assists in locating the correct place/position
• Focus on your breath—exhale and relax your pelvic floor as you stretch the tissues.

When to Avoid Perineal Massage

• If you have an active vaginal infection or any other medical concern/risks during your pregnancy —consult your healthcare provider first.
• If you experience pain or discomfort that doesn’t improve with adjustments, stop and discuss it with your physiotherapist or treating health care provider

If you’re unsure about your technique or want personalised advice, book a session with a pelvic floor physiotherapist. They can guide you through the process to ensure you feel confident and prepared for your birth experience.

You’ve got this! 🌸