Did you know perineal massage has been shown to decrease the likelihood of perineal trauma (mainly episiotomies) during birth and reduce ongoing perineal pain postpartum ?

AWESOME.

But you’re probably asking yourself….

How do I even start?

How do I do it?

How often should I do it?

Working in women’s health physiotherapy I realize that many expecting mamas are not told about this valuable and important technique and every day in my practice I see their confused faces when I mention perineal massage-  so here it is! Your step by step guide for perineal massage.

Side note:  I recently created an online course with my partner Katie Kelly, Prenatal Pelvic Health: Pelvic Floor & Core Basics. And it’s almost ready!  This course will cover how to to prepare your core and pelvic floor for pregnancy, birth and postpartum.  So if you’re looking for a little more guidance or want to be proactive about your core and pelvic health. Sign up for our mailing list here. 

 

 

Why do we do it?

The goal of perineal massage is to increase tissue elasticity (stretch) in order to reduce tearing during vaginal birth- and we know that the rates of perineal tearing among first time moms in Canada is very high. About 80% of first time Mom’s experience some form of perineal tearing.

 

What does the research say?

A 2013, review by Beckman & Stock (2013) concluded that digital perineal massage reduces the likelihood of perineal trauma (mainly episiotomies) and ongoing perineal pain postpartum and is generally well accepted by women. As such, women should be made aware of the likely benefit of perineal massage and provided with information on how to massage.

 

So How do I do it?

Here’s your DIY Playbook for Perineal Massage

  1. Get comfortable. Lay in a semi-reclined position in your bed with your knees bent. Make sure you relax! Being as relaxed as possible is essential.
  2. Use clean hands, with trimmed short fingernails and a good water-based or silicon based lubricant Click the links to check out some of my faves.
  3. Picture your vaginal opening being a clock face. The bottom of the vagina is 6 o’clock and the top is 12 o’clock
  4. Using your pointer finger or thumb (most patients prefer their thumb) take a nice deep breath, relax and insert the tip of your finger/thumb in the vaginal opening to the first knuckle.
  5. Starting at 6 o’clock take a nice big breath and as you relax apply a stretch downward toward the number 6.
  6. Stretch should be strong, stingy maybe, and slightly uncomfortable but not painful. We want to ensure we are actually stretching the pelvic floor and perineum.
  7. Hold for ~ 30 seconds
  8. Move to number to 7. Repeat the stretch at each number of the clockface until you’ve worked your way around.
  9. As you move up to around 9 o’oclock it is sometimes easier to switch to your finger v.s. the thumb
  10. Start with 3 minutes and work up to 10 minutes. Practice 3-5x/a week.
  11. As you practice this it should get noticeably easier to do the stretching
  12. As it gets easier increase your pressure, or add stretch in two directions using both thumbs/finger.

One Last thing.

As always, although I am a physiotherapist. I am not YOUR Physiotherapist. Perineal massage is not always advised in some cases. So make sure you check with your physician or healthcare provider before starting at around 36 weeks.

 

There you have it ! Your DIY playbook for perineal massage

Have Questions or having trouble? Book an appointment

Or reach out to a pelvic floor physiotherapist in your area.

Have a friend who’s expecting? Share this post with them.

 

References:

Beckman & Stock (2013). Antenatal perineal massage for reducing perineal trauma. Cochrane Database Systematic review. Volume 4.

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