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How To: Perineum Massge

Okay, let's get a bit intimate, and chat about a great way you can start to prepare your body to deliver your baby - perineal massage!

There is a lot of fear that surrounds birthing your babe, tearing is commonly a big concern, but before I go into this technique, I need to explain to you what a perineum is. Both women and men have them its the area between the back passage and genitals.

You may have heard the term 'ring of fire'. It's the term given to the commonly experienced type of burning sensation that occurs when your baby's head crowns or starts to appear at the birthing canal once you are fully dilated. It's an intense sensation - right now I want to take you through why perineal massage is beneficial and also, how to do it!


The burning feeling you get is because your vagina is stretching intensely to allow for baby to be birthed. During this crowning phase, under the enormous amount of pressure, the perineum can tear. I do want you to know and understand that tearing is quite common, 8 out of 10 women who birth vaginally will experience some level of trauma to the perineum. Thankfully, most of these are minor - 1st or 2nd-degree tears and heal with no long term issues, but 3% of women will have a 3rd or 4th-degree tear. These can be quite serious and cause longer-term complications for women, including the inability to control bowel movements, ongoing pain, discomfort and problems with intercourse.


Types of Tears

  • A 1st-degree tear is a shallow tear, more often than not these do not require stitches and heal on their own

  • A 2nd-degree tear is a tear to the skin and muscle layers of the perineum. 2nd-degree tears heal better when they are repaired with stitches

  • A 3rd-degree tear is a tear through the perineal muscles and into the ring-shaped muscle that surrounds the anus

  • A 4th-degree tear goes through the anal sphincter and into the anus

Image: Mommy Labor Nurse


This is why preparing your perineum, and doing everything you can to reduce your chance, and severity of a tear can be so beneficial - and this is where perineal massage comes into the picture.


Research has shown that women experiencing their first vaginal birth, who practice perineal massage from 35 weeks of pregnancy, have a lower risk of serious tearing or episiotomy, and report experiencing less pain after birth. You'll also get familiar with the feeling of that stretching, and be more aware of how to manage the pushing phase when the time comes.

So, why does massaging the perineal area help?

The massage helps to soften the tissues your baby stretches during delivery.


And what is it exactly?

As it sounds, you massage and stretch the skin of the perineum.

However - you shouldn't do perineal massage if:

  • You're not yet at least 35 weeks

  • You will not be having a vaginal birth

  • You have herpes or thrush

  • You have placenta praevia (a low–lying placenta) or any other condition where there is bleeding from the vagina during the second half of pregnancy

  • You don't want to do it, of course!

Before you start, make sure you check with your doctor or care provider to see if it's appropriate for you.


You can start massaging the perineum from 35 weeks, and it can be done by you or your partner - as it might be a bit tricky with your belly in the way. You'll need to purchase a water-soluble lubricant or natural oil like sweet almond oil - you want to make sure you are using something that is safe for down below and is unscented. Start by doing the massage 1-2 times per week for about 5 minutes each session.

Let's get ready:

  • Firstly you will need to empty your bladder and wash your hands - make sure nails are clean and trimmed also

  • Find a relaxing place to perform the massage like the bathroom, bedroom, or anywhere else you are comfortable. Lie down, and position yourself comfortably

  • Use a mirror to become thoroughly familiar with the vaginal opening and the perineum

  • A warm bath or warm compresses on the perineum for 10 minutes before the massage may help you to relax and increase blood flow to the area

Now you're ready here's how it works:

  1. Apply oil to the perineum and thumbs

  2. Place your thumbs just inside the vagina to a depth of three to five centimetres. Gently press downward towards the rectum and to the sides of the vagina at the same time to stretch the opening, until a very slight burning, stinging, or tingling sensation is felt. If your partner is helping you or performing the massage for you, they need to use clean hands and one or two index fingers inside the lower part of the vagina. It is important to tell your partner how much pressure to apply without causing pain

  3. The massage can be done in one direction at a time, i.e. from side to side, or the thumbs can be swept in opposite directions

  4. Try different ways until you find which is more comfortable for you

  5. Focus on relaxed breathing while trying to consciously relax the pelvic floor muscles and allowing the tissues to stretch. Relax and repeat this process again

Video: Doulaalacati


I know that a lot of women are anxious about tearing - this is a simple and effective way to reduce the likelihood of a significant tear, so have a chat with your care provider about perineal massage to see if its safe for your pregnancy.

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