Once you are into the third trimester of pregnancy, you should start preparing your body and mind for the forthcoming task. You should do some exercises and practice some relaxation techniques so that your delivery becomes easy. Massage, especially perineal massage, plays a very important role in preparing your body for the hard task.
What is perineum? Perineum is the area between the anus and vagina. During normal delivery, when the baby’s head is pushed, this area tends to tear because of the pressure. Sometimes, even doctors provide a small cut in the perineum to enable the baby’s head to come out easily. Thus, in order to reduce the trauma, the perineum needs to be strengthened some way. The best way to do this is through perineal massage.
Perineal massage is massaging the perineal area of the body i.e. the area around your vagina to loosen the muscle between the vagina and perineum. Doing perineal massage daily will increase the ability of the muscles in that area to stretch. This causes less tear and less medical intervention when the baby’s head is pushed during the final stage of labor.
Tearing of the vagina normally happens in the below situations. Thus, it is advisable to undergo perineal massage
- Before your first delivery
- When the baby’s head is in an abnormal position (which will be evident from the scan)
- The baby is very big
Tearing during delivery can be classified in to four degrees. First degree tearing involves only the perineal area, a second degree tear involves skin and perineal muscle and the third and fourth degree tear involves the anal area as well. Thus, undergoing perineal massage regularly helps preventing the tear to a greater extent.
Studies have shown that taking a warm bath or applying a warm pack in the perineum area helps in reducing the pain in that region during delivery. Thus, along with perineal exercise a warm pack can also be applied to reduce the pain and tearing.
How to do perineal massage?
You can do perineal massage on your own or you can ask your partner to help you out. If you are doing it on your own, it would be advisable to place a mirror on the opposite side so that you can see what you are doing. Select a comfortable place where you can relax. Before you start the massage make sure that you have washed your hands well and that nails are trimmed and cleaned.
- Sit or lie down in a comfortable position with your legs apart. You can also stand with one leg on a chair. You can do the exercise either in the bathroom after a warm bath or even in your bedroom. Use a vitamin E oil or vegetable oil to lubricate your fingers. Make sure that only enough oil enters the vagina so as not to disturb the natural oil balance.
- Place your thumb about 1 inch inside your vagina. Press towards the rectum and side at the same time. Continue pressing till you get a slight burning sensation. If your partner is helping you out with the massage he can use the first and second fingers of both hands.
- Hold the stretch for about 2 minutes and then relax.
- Massage in a U-shaped motion from the side of the vagina going down and then back to the other side of the vagina. Start slowly with a 1-minute massage and increase it to 5 minutes as you feel more comfortable.
- Be very gentle during the massage as otherwise it can cause swelling. Also, remember not to press too hard over the urinary opening as it can lead to infection.
Advantages of perineal massage
- During delivery, when the baby pushes its head against the vagina there are chances for vaginal tearing. But perineal massage helps in strengthening the vaginal muscle thus reducing the chance for vaginal tearing.
- Since the vaginal muscles are strengthened through perineal massage medical assistance in the form of forceps and vacuum extraction can be reduced to a great extent.
- The vagina is able to stretch better as a result of the massage. Because of this only less pressure is exerted on the baby’s head during the final stage of labor.
- Perineal massage helps in reducing the pain during crowning.
- Since the vaginal tear and the use of forceps are minimized, the postpartum recovery is very fast.
- Perineal massage familiarizes you with the stretching that happens during delivery.
- The increased stretching power of vagina reduces the chance for a C section
However, you should not do perineal massage if you suspect herpes, vaginal thrush or any other vaginal infection. Applying lubricants and exercising the vaginal muscles at this stage can worsen the situation.
The right time to start perineal massage is when you are 34 weeks pregnant. You can do it once or twice a week depending on your time limits. It should always be done gently and should not hurt your groin. If perineal massage is done the right way, you will notice the skin and muscle surrounding the vagina loosening up. Perineal massage along with pelvic floor exercise helps in strengthening your pelvic area.
Nowadays, various perineum stretching devices are available in the market to ease the pain and reduce the tearing during delivery. But most of the doctors are against using artificial methods or devices for a phenomenon as natural as delivery. Similarly, doctors are also against doing perineal exercise when the woman is in labor as it can add to her trauma.
However, when it comes to the medical side, there are mixed opinions from the doctors and midwives regarding perineal exercise. While some studies show that perineal exercise helps reduce the perineal trauma to a large extent, others show that there is no direct link between perineal exercise and trauma. Thus, we can conclude that the success of perineal exercise varies depending on the person. While it can be successful for some it may not be so for others. A pregnant mother’s body structure also plays a very important role in perineal trauma.
Author: Samantha Jones RN