Perineal Massage: How to Perform It

Perineal massage during pregnancy helps prevent episiotomies and tears. Here, we'll tell you how to do it. Don't miss out!
Perineal Massage: How to Perform It

Last update: 07 September, 2021

The perineum or pelvic floor plays a fundamental role during childbirth, and it’s important to prepare it during pregnancy. Perineal massage is a simple technique that promotes muscle elasticity and prevents tears and episiotomies.

This practice is highly recommended for women in their first pregnancy, to help them recognize their own bodies. However, other positive benefits have been demonstrated for mothers who have already had other children, and there are very few contraindications.

Here, in the following article, we’ll tell you how to put them into practice.

Recognition of the pelvic floor

Before practicing a perineal massage, you need to locate and recognize the area you’re going to work on. You can use a mirror to better visualize your pelvic floor or just feel it, becoming aware of all the structures that are in it.

Another very useful way to recognize the perineum is to sit on a pilates ball or cushion. Make sure that your feet make contact with the floor and that your knees are wide apart.

Put your pelvis in a neutral position and feel the muscles that come into contact with the surface of the ball. If you feel the area below the buttocks with both hands, you’ll see that it looks like a rhombus formed by the ischia on both sides, the pubis in front, and the coccyx behind. All this is the pelvic floor, and that’s where you’ll apply the massages.

Step-by-step instructions for perineal massage in pregnancy

Perineal massage can be done every day, but in order for it to be effective, we recommend doing it at least once or twice a week.

For the massages, you’ll need a gliding medium, which can be pelvic floor-friendly oils (such as almond oil) or a water-based lubricant. If you wish, you can help yourself with a mirror to facilitate the recognition of the area.

Here are the step-by-step instructions for perineal massage.

1. Try to perform the massage in an intimate and comfortable space

A pregnant woman in a bathtub with candles.

The person who performs the massage should have short nails and properly sanitized hands. It can be yourself or someone you trust, such as your partner.

The position you adopt will depend on your comfort. You can lie on your bed, half-sitting, with several pillows behind your back to relax. Another option is to sit on the toilet or lie down in the bathtub.

2. Recognize the area to be treated

After getting comfortable, begin to gently explore the perineal area. Put the cream or lubricant on your hands and pelvic floor so that the massage doesn’t cause discomfort. If you perform a self-massage, you’ll use your thumbs. If it’s another person who applies the massage, they’ll use their ring and middle fingers.

3. Start with the massages

To begin, you should insert your fingers at the entrance of the vagina, just a few centimeters (no more than 4). Gently slide them sideways, as if trying to enlarge the diameter of the cavity.

Then, do the same upward, in the direction of the urethra, but without going all the way to the urethra. If you can tolerate it, keep pressure on that area for about 3 to 4 minutes.

Finally, try to repeat this exercise at the opposite end, i.e. towards the anus. Place your fingers at the angle where the labia majora and labia minora meet. Hold the pressure for about 4 more minutes.

4. Give your muscles time and stay consistent

You may feel warmth or discomfort at first, but you’ll find that, over time, the area will begin to relax and loosen up. You’ll also begin to become familiar with some of the new sensations you’re likely to experience on the day of delivery.

You don’t need to do it all at once; it’s best to respect your own time and your body’s time. If, at any time, you feel pain, stop the massage and try again another time.

A pregnant woman sitting in bed rubbing her belly.

Precautions for perineal massage in pregnancy

Although perineal massage is a safe and simple technique, you must take into account some precautions when performing it.

The first consideration is not to perform them before the 34th week of gestation in order to avoid complications. Also, before starting them, talk to your doctor about it.

As for the technique, it’s important to do it gradually. First, start with external massages and then continue with internal massages, slowly and progressively increasing the pressure. It’s important to massage both areas to get the entire pelvic floor musculature to relax. Be sure to apply gentle but firm pressure so that it has an effect, without causing pain.

Finally, use a sufficient amount of lubricant to avoid damaging the area and maintain an adequate level of hydration every day. This way, your tissues will be healthy and strong to face the new stage that’s about to arrive.

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