A mother’s body undergoes a marathon of changes from conception through delivery. Your body prepares for many of those changes all on its own. For other changes, you may want to help your body along. That’s where perineal massage may be useful.
What is perineal massage?
The perineum refers to the thin tissue between the vagina and anus. Perineal massage, therefore, refers to massage targeted specifically at this area.
Why is perineal massage necessary during pregnancy and childbirth?
Well, necessary may be a bit of a stretch (I chose that word intentionally. Sometimes I just can’t help myself.)
Many labor and delivery workers, especially midwives and natural childbirth advocates, recommend massaging the perineum near the end of pregnancy. The idea is that it can prepare the delicate perineal tissue for the intense stretching it will undergo during the birthing process.
These same practitioners may utilize perineal massage during birth itself. Again, the goal is to help the tissue stretch more gradually to prevent tearing.
Does perineal massage work?
Like so many tactics and techniques for preparing for childbirth, the research is mixed. Some studies have shown significant benefits. Others have shown little advantage to its use.
Further complicating matters, some of the studies used to draw conclusions are relatively low quality.. That doesn’t exactly spell confidence for pregnant women considering the technique.
There is some good news here though. The ACOG (American Council of Obstetricians and Gynecologists) has evaluated the evidence. Their conclusion is that there is some benefit to perineal massage during the late third trimester and/or the second stage of labor. (The second stage is active labor — when you actually deliver the baby).
“Perineal massage, either antepartum or during the second stage of labor, can decrease muscular resistance and reduce the likelihood of laceration. Moreover, use of warm compresses on the perineum during pushing can reduce third-degree and fourth-degree lacerations.”
That sounds promising! Even better — there are no major risks to this technique. Assuming you have your OB’s okay and you (or your partner) use clean hands, you have nothing to lose by trying perineal massage as your pregnancy progresses and delivery approaches.
How often should you massage your perineum?
Assuming you decide to give it a try during your third trimester, you may have questions.
My Expert Midwife feels pretty strongly about the importance of perineal massage during pregnancy and she has a ton of related resources on her website. She recommends starting to massage the perineum at 34 weeks pregnant, three to four times per week.
She even has a YouTube video on her website to show you the proper way to do it if you need some extra guidance.
Is it too late to get started?
Don’t worry if your delivery date is right around the corner. If you’re still pregnant, it’s not too late to give this technique a try. Plus, the ACOG has said there are benefits to massaging the perineum during labor itself.
Have a conversation with your provider about their delivery process. Do they typically use perineal massage during active labor? If not, why?
These are all important questions that can help you and your provider get on the same page. If you feel strongly about it, you could even consider putting perineal massage into your birth plan, if you have one.
How you prepare your body for birth is completely up to you. But if you’re open to it, perineal massage could make things easier for you once you reach the delivery room.