Perineal massage & tearing in birth

As a midwife, I can strongly say that one of the biggest fears I see in women is their fear of tearing during birth. 

I totally understand this fear and work through this with all my patients. Tearing in birth is very common, however, the degree of a tear can vary greatly. Most of the time, you won’t feel if you tear, the body is amazing like that! However, there are other complications that can result from tearing and different levels of tears that a woman may experience. 

I want to chat about perineal massage, a simple and effective tool that reduces your likelihood of tearing, needing an episiotomy, allows you to familiarise yourself with the feeling of stretching for birth and assists with an easier and better recovery after birth.

Perineal massage is as it sounds, massaging and stretching the skin of the perineum (skin between vagina and anus). The perineum connects with the muscles of the pelvic floor. The pelvic floor is incredibly important, a hammock of muscles supporting your pelvic organs. 

Perineal massage is known to have the greatest benefits with your first birth, however, there is no harm in doing this with all pregnancies. 

Perineal massage is recommended to all women in Australia (going through the public system anyway!) from 34 weeks, who are planning a vaginal birth. There is, of course, women who cannot or do not wish to have a vaginal birth, if this is you please do not attempt this. 

It can be done by you, or your partner if you are comfortable with this, as it can be tricky to do with a belly in the way. You can use a pure, organic pharmacy grade oil to do the massage (unscented, and safe for that region). 

I have included an image below that gives you a good understanding of how to perform the massage. You can start 1-2 times a week for 5-10 minutes. 

1.) Wash your hands and make sure they are clean

2.) Having a shower or applying a warm washer to the perineum can promote blood flow

3.) Get in a comfortable position

4.) Using 1 or both of your thumbs, insert them 3-4cm into the vagina. Gently push down towards the rectum, slowly stretching the perineal skin and hold until a slight stretch/sting is felt.

5.) Use your thumbs to sweep from side to side in a “U” shaped motion for approximately 1-2 minutes

Do not do perineal massage if you:

• Are less than 34 weeks pregnant

• Have herpes

• Have thrush

• Are not planning a vaginal birth

• Have not checked with your doctor 

Always consult a medical professional before attempting

Image from the amazing MomJunction