The perineum is the area between your vagina and anus and is especially important for all women. During labour this area has to stretch greatly and often can tear. Perineal tears can lead to pain and problems with urinary or faecal control and pelvic organ prolapse.
Perineal massage is a way of preparing your perineum to expand more easily during childbirth and reduce the risk of these tears. This is especially effective for your first delivery. A 2013 review including 2497 women showed that doing perineal massage once or twice a week from 35 weeks lessened the likelihood of perineal trauma including the use of episiotomy (small surgical cut).
How to do perineal massage
Be in a position and place where you feel comfortable. After a hot shower and with empty bowels can be a good idea. Having a mirror is useful so you can see the area.
First you can work externally: Place one or two fingers on the skin of the perineum and with pressure so your fingers don’t just slide on the skin massage and stretch the area.
Next you work internally: Put one or both thumbs on the back part of the vaginal opening so your hands/fingers will almost cup your bum.
Press your thumb(s) downward toward your back passage. Then with that pressure you move the thumbs side to side in a U- shape.
You should feel a stretchy sensation but don’t work so much that it is painful. You are trying to relax and let go of the muscles all the time. Your tolerance and the pliability should increase with practice. You can do as frequently as you like but typical clinical advice is once a day for 5 minutes.
It’s best to avoid perineal massage if you have any infection or virus such as vaginal herpes or warts. If you have a high risk pregnancy first check with your obstetrician.
Be cautious and discuss with a women’s heath physiotherapist first if you suffer with pain in that area for example with tampon use or intercourse.