Have you ever wondered if there is anything you can do to prevent tearing and pain from childbirth?
If you are in your third trimester, it is time to start thinking about perineal massage.
What is this you ask?
Perineal massage is an easy way prep your vagina in the third trimester so you can decrease your risk of trauma and tearing during birth! And we are going to get to all the nitty gritty details in this post.
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What is Perineal Massage?
A massage sounds great doesn’t it? But that word perineal…is that a plant?
The word perineal is actually fancy medical jargon referring to the fleshy tissue between the opening of the vagina and the anus. Nurses don’t like to go around saying vagina all the time so we came up with PC words like perineum and perineal.
So yes, I am basically suggesting that you “prep” your vagina to birth a child by giving it a massage.
But this isn’t any ole massage.
Oh no, a perineal massage takes some finesse, especially since that area of the body can be quite hard to reach when you are at the end of pregnancy.
When should you start doing perineal massage?
You can start doing perineal massage as early as you want, but the reality is you have to keep it up in order to benefit from it.
Think about perineal massage as stretching for your vagina.
You may have stretched your little heart out in college and were a flexible little bean. But maybe now you are pushing 30, and let’s be honest, ain’t nobody got time for stretching anymore!
Just as you are no longer reaping the same benefits of your cheerleading days, your perineum can lose the “stretch” if you forget to do it.
I personally started doing perineal massage in my third trimester, around 34 weeks. I set an alarm on my phone for 9 pm to remind myself to do this.
How often should you do perineal massage?
A good rule of thumb is to shoot for 3-4 times a week.
The reality is it can be a bit awkward to actually massage the perineum when you are 8-9 months pregnant and it probably won’t be something you look forward to doing.
If you have a loving partner who isn’t grossed out by bodily functions you can ask him to help you in this department.
If this is a husband doing some research for his wife, bless your sweet soul! Don’t you worry, I will tell you how to give your wife a perineal massage near the end of this post.
But before we do, I just want to give you a little motivation for this awkward task ahead.
What are the risks of internal tearing during childbirth?
The perineum is at high risk from tearing during birth, especially if this is your first kid. In fact, only 10% of first time moms get through the birthing experience with an intact perineum. (source)
The good news is the majority of women only have minor tears, which heal quickly and only require a stitch or two. There is a small percentage of women, estimated to be around 3-11%, that will endure a third dgree tear or greater. (source)
Internal tearing of the perineum is more likely to happen to you if you have an assisted birth with forcepts or a vacuum, your baby is in the occipito posterior (OP) position, or you have a large for gestastional age baby. (source)
Some symptoms and complications that are associated with 3rd or 4th degree tears include:
- Increased pain
- Difficulty sitting down or sitting for long periods
- Burning sensations
- Increased risk of bleeding
- Increased risk of infection
- Improper healing that may require surgery
- Painful intercourse
- Pelvic floor dysfunction
- Difficulty having a bowel movement
- Difficulty urinating
What are the benefits of perineal massage?
Since none of those things sound very fun, there are plenty of things we can do to help in this department, starting with perineal massage.
Perineal massage allows the skin and muscles tissue to relax so it will be less prone to tear.
Perineal massage also helps break up scar tissue from previous births or other trauma (like horseback riding) which naturally increases skin elasticity.
If you do perineal massage regularly at the end of pregnancy, you will also likely experience less pain after birth. (source)
I personally found perineal massage to be very helpful. I had a quick labor and birth and only required two stiches. I also didn’t have a lot of pain down there while I was healing.
You may read in some places on the internet that there isn’t any scientific evidence that proves perineal massage prevents tearing. I have personally spoken with many moms who did it and got great results!
As long as you wash your hands before you start it doesn’t cause any harm so why not give perineal massage a try!
How to do perineal massage on yourself
→ Before you start to do perineal massage it’s important to get in the right mindset. You will have to find something that works for you but for me it meant diffusing some lavender essential oil, fixing up a warm washcloth, and doing a warm compress down there for a few minutes while taking some deep calming breathes.
I know it seems like strange advice to get in a mindset to massage your vagina but trust me on this one. This massage is not exactly relaxing so you want to do something to make the experience more pleasurable.
If you start perineal massage in the first part of the third trimester, you will be doing this at least 3 times a week for the next 6-8 weeks. That’s some serious commitment!
→ After you are all zen, it’s time to begin your massage. Wash your hands with soap and water. Please don’t skip that part! Then grab a massage oil.
I liked to use coconut oil as my main massage oil for the perineum but you could also use olive oil or sweet almond oil.
Coconut oil is a great oil for perineal massage because it contains anti-inflammatory properties. (source) Basically while you are stretching things out down there, you are also using an oil that nourishes skin and reduces injury.
→ Find a position that allows you to reach your perineum and lather your first two fingers and thumb with your chosen massage oil.. This could be lying down on your back or even standing up in the bathroom with one leg propped on the commode.
→ Place your thumb about one inch inside your vagina and firmly press downward on the skin as you move your thumb toward your anus. You should feel a pulling sensation on the bottom of your perineum. Repeat this for one minute.
→ Once again begin with your thumbs or first two fingers inside your vagina and press down gently as you guide them out horizontally towards your legs. You should feel a pulling sensation on the middle of your perineum. Repeat for 1 minute.
→ Lastly you will start with your thumbs or first two fingers inside your vagina and firmly press outward and upward. Repeat this for 1 minute.
During your massage it is common to feel a slight burning sensation on the skin. The perineum is a very sensitive part of the body and this is totally normal. Try your best to complete the entire massage for the full minute but if you cannot tolerate it, you can work up to a full minute.
Just remember that you are helping your perineum to loosen up before the big day!
How to give your wife a perineal massage
This part is for those loving husbands or partners out there who care about keeping their wife’s lady parts as healthy as possible!
The first thing I will mention is try not to think about this as a sexual act but more of a matter of business. Then again if your wife or partner is still very much interested in sex by this point, you could offer that because it will increase the blood flow to the area which will provide more oxygen and nutrients to the tissue you plan to stretch.
Just don’t forget about the massage part!
Follow the above steps except you will have to work together to find the right pressure application.
A perineal massage should not hurt but it shouldn’t feel like a soft caress either. She will need to be a bit uncomfortable to make progress. Your wife should have the same reaction she would if you were helping her stretch her legs. Remind her to breathe through each part of the massage.
The biggest difference from a self-perineal massage versus one from a partner is you are able to cover more surface on the downward portion of the massage.
Use your pointer and middle finger together for the downward and outward portion and your thumbs for the upward portion.
**Make your wife a pregnancy survival kit full of little comforts when pregnancy gets tough!**
What else can you do to prevent tearing?
As we mentioned earlier, the statistics aren’t really in our favor to get through birth completely unscathed. Although women’s bodies are designed to birth you can ask your nurse or midwife to place a warm washcloth on your perineum while you are pushing.
This will help increase the bloodflow to the area right before it has to stretch.
Should you have some minor tears or a few stiches you can take postpartum sitz baths a few times a day followed by applying cold packs.
This hot and cold alternation helps to reduce swelling and inflammation.
Related: How to make a postpartum sitz bath
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