Fast facts
Many individuals experience some degree of pelvic floor dysfunction after giving birth, with bladder and bowel control a common challenge.
While these postpartum pelvic health issues aren’t always avoidable, there are steps you can take to maintain a healthy pelvic floor, including perineal massage.
Below, we explain why the practice of perineal massage is an important component of childbirth prep during the final weeks of pregnancy. (Yes, one more thing to add to your third trimester to-do list, but we promise it’s worth it!)
The perineum is a portion of the pelvic region located between the vagina and anus. It also covers part of the birth canal.
The tissues in this area contribute to the overall condition of your pelvic floor, supporting your posture and preventing urinary and fecal incontinence, among other functions.
Perineal tissue should be strong yet flexible enough to prevent tearing during labor and delivery as your baby descends in the birth canal. That’s where perineal massage comes in.
Perineal tears are one of many factors in postpartum pelvic floor issues, particularly urinary and fecal incontinence.
Tearing is common — about 40-80% of birthing people who deliver vaginally have a tear in the perineum, with two-thirds requiring stitches.
Regular perineal massage during the final weeks of pregnancy lowers the risk of tearing during childbirth. Additionally, it can lower the severity of any tearing that does occur and reduce the risk of episiotomy.
The technique consists of stretching the perineal tissue with your fingers so that it can more easily stretch over your baby during labor and delivery. You can massage your perineal tissue on your own or have your partner help.
Wash your hands with a mild soap and trim your fingernails, if needed, for maximum comfort during your massage.
Find a private, quiet space and a comfortable position from which your hands can easily reach your perineal tissue.
Experiment with different positions to find what’s most comfortable for you.
Apply oil or lubricant to your fingers. This will help minimize friction as well as hydrate the perineal tissue.
Since vaginal tissues are highly absorbent, it is not recommended to use products with additives, chemicals, scents, dyes, or glitter, or any with a warming, cooling, or tingling effect. Aloe-based lubricant is typically a good option.
Begin the massage using your thumbs or fingers to apply pressure at the vaginal opening. This encourages blood flow, which is necessary to manually manipulate the tissues. A warm compress can also help.
Place your thumbs or fingers about an inch inside of your vagina. You can use one or both thumbs, your index or middle fingers, or two fingers. Do what feels best for you.
Press your thumb(s) or finger(s) along the back portion of your vagina toward your anus and side to side. It’s important to apply enough pressure. While this shouldn’t feel painful, you might experience a slight burning or stretching sensation at first.
Apply pressure with your thumb(s) or finger(s) in a stretched position for 10 seconds. Release for 2-3 seconds before applying pressure again.
Repeat this pattern for 1-2 minutes. Then, sweep your thumb(s) or finger(s) from the center of the vaginal canal out to the sides and then back, in a U-shaped motion.
Continue for up to five minutes.
Some people experience initial discomfort when massaging their perineum, but it will become easier and more comfortable with time.
To have your partner perform perineal massage, have them sit facing you with their legs crossed. Drape your legs over theirs for support and comfort. They should use only their index fingers during the massage.
Follow the same steps. Begin with applying pressure, gently stretching and releasing the tissue, and then creating a soft hook with the two index fingers.
Use the hook shape to gently massage downward and outward from center, slowly sweeping back and forth.
At Ruth Health, we understand that nobody knows what you need better than you. We provide expert, evidence-based maternal advice so that you can make the best decisions for yourself.
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