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The Pilates PT Blog

Perineal Massage: What Is It, And Is It Worth the Hassle?

Is perineal massage worth it? I’m going to jump straight to the answer and say YES! However, surveys have shown that women do not know what perineal massage is, when they do know of it, they are often too embarrassed to do it and many do not know the benefits and therefore do not consider it part of their antenatal ‘self care’. There is also uncertainty as to how to do it. So, let me take this opportunity to address these points and help you see that perineal massage is worth it because quite simply you are WORTH it!

 

What is perineal massage?

 

Perineal massage is the act of stretching the perineal tissues, preparing them for childbirth and making them more ‘elastic’. This can be carried out from around 34 weeks pregnant for around 3-4 minutes, 3-4 times a week.

 

Are there any benefits?

 

Absolutely! Let’s be honest, one of the fears surrounding a vaginal delivery is tearing. 90% of women will experience some form of tearing around the perineum during a vaginal delivery. This of course ranges from small grazes to more significant tears that require stitches.  Perineal digital massage has been shown in studies (see the Cochrane review 2013) to reduce the likelihood of either tearing or having an episiotomy by around 9% and has also been shown to reduce ongoing perineal pain (in women who have birthed vaginally before).

Even if you are planning on having a caesarean section, I would recommend still carrying out perineal massage, just in case your baby decides to come a little earlier than planned and is delivered vaginally!

 

How do I do perineal massage?

 

  • Have a warm bath to help relax the area
  • Make sure your hands are clean before starting and nails are short
  • You can use a vaginal lubricant or almond (or olive) oil for comfort
  • A great place to do this is on your bed. Sit upright and supported, bend your knees up and then let your knees fall out to the side (you can support your knees with pillows).
  • Massage the oil into your perineum
  • Gently place both thumbs (if both is too much place one thumb) into the opening of your vagina (see diagram below) and rest your fingertips on your bottom

 

 

 

  • With a light pressure press down towards the anus until you feel a stretch (or light burning sensation). Hold for up to a minute
  • Now make a sweeping motion side to side. Visualize your vaginal canal like a clock with 12:00 being at your pubic bone and 6:00 at your rectum. You are stretching from 3:00-9:00 like a U.
  • The stretch will be intense but should not be painful. It should get easier as you practice it.
  • Keep relaxed and take deep breaths as you do this.
  • If you really do not want to do this, you can ask your partner to help with this technique

 

When not to do perineal massage

 

If you have had vaginal bleeding, an active infection or a ruptured membrane then please do not carry out perineal massage without consulting with your midwife or GP first.

 

If you are still unsure then of course speak to your midwife of even ask a pelvic health physiotherapist to guide you because this technique is so worth getting comfortable with. Yes, initially it does feel weird, but the benefits could very much be worth it.

If you have any further questions about perineal massage do feel free to contact me @physiomumuk

 

Helpful Resources

 

  • Follow Emma Brockwell on Instagram here
  • Listen to the ‘At Your Cervix’ Podcast here

 

If you enjoyed reading this article on Urinary Incontinence by Emma Brockwell and would like to discover more about prenatal fitness and your changing body I would love you to check out and try my pre & postnatal plan ‘The Bump Plan’ out for FREE today – simply click here to get started

 

 

Emma Brockwell

Emma is a specialist Pelvic health physiotherapist focusing on problems related to the pelvic floor and pelvis. These include incontinence, bladder and bowel dysfunctions, pelvic organ prolapse, pelvic pain, constipation, painful intercourse as well as aches and pains during pregnancy. She specializes in helping post-natal women return to running and exercise, in addition to leading a popular running group and helping women meet their running objectives. She has co- authored published returning to running postnatal guidelines for medical, health and fitness professionals. She is passionate about treating all women with the highest level of care. She is the co-host of At Your Cervix - The podcast and has her first book, ‘Why Did No one Tell Me’ due out in 2021.

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