Perineal massage is a very simple technique that aims to increase the elasticity of the perineum muscles, in order to minimize the risk of tearing during childbirth. What is sought with this massage is to reduce muscular resistance and promote blood circulation in the area, in addition to increasing knowledge of one’s own body (if it is you who is performing the massage) or strengthening the bond as a couple (if it is your partner who does it to you).
Saray Losarcos, midwife of the online platform ‘Mis Matronas’ created to provide support, solutions and support to pregnant and postpartum women, explains how to put this technique into practice and what its main benefits are .
What is perineal massage and how can it help in childbirth?
As we said at the beginning, perineal massage is a technique that helps to increase the elasticity of the muscles and tissues of the perineum , reducing muscular resistance and promoting blood flow to the area.
However, the midwife insists that although perineal massage can be a great help, it does not ensure that we cannot suffer a perineal injury or trauma during childbirth, since there are various risk factors that can cause it, such as instrumental delivery, the maternal position during the delivery, the type of push, the time of delivery, the weight of the baby …
Likewise, massage would not help prevent an episiotomy , because as Saray explains “episiotomy is an indicated technique in very specific cases (and never routinely or as prevention of tears) in which it is necessary for the baby to be born at the oldest as soon as possible “ .
Who performs the perineal massage?
It is not necessary for the perineal massage to be performed by a professional , although if you wish you can go to a midwife or physiotherapist specialized in pelvic floor to practice it, or explain how to do it.
You can perform the perineal massage yourself , which will help you increase your confidence in your body and better understand the area of the perineum involved in childbirth. All this will contribute to better channel the sensations and facilitate the baby’s transit through the birth canal.
If you decide to let your partner do the massage for you , this technique will help strengthen your bond, encourage their involvement in the development of pregnancy and your care, and contribute to the preparation for childbirth.
“Labor is a moment of high hormonal power and nothing can be compared to the pressure of the baby’s head on the perineum, but it helps the perception and understanding of sensations. Sharing this moment as a couple favors the creation of the bond, improves communication and participation in the whole process “- says the midwife.
What time of pregnancy is the best to practice it?
The right time to start perineal massage is between 32 and 35 weeks of pregnancy . The studies carried out recommend doing it between two or three times a week at least, with a duration of between five and ten minutes.
In any case, there is neither frequency nor maximum time when it comes to doing it.
Can it also be done postpartum?
Perineal massage not only has benefits if it is performed during pregnancy, but also in the postpartum period it provides advantages , since it favors the healing of perineal trauma and episiotomy in case it has occurred during childbirth, improving the oxygenation and elasticity of the tissue.
However, before performing it, it is essential that a professional perform an adequate assessment of the pelvic floor in its entirety, and if they consider it, you can proceed to perform the massage according to their indications.
Contraindications of perineal massage
Perineal massage has three contraindications:
- Presence of vulvar varicose veins
- Vaginal infection
- Urinary infection
What does the perineal massage feel like?
The fundamental rule of perineal massage is that it does not have to hurt . A slight pressure or a slight stinging may be felt, but in no case pain. The pain produces a reflex contraction, and what is needed is for the muscle to relax. On the other hand, the fear and defense circuit is activated and the exact opposite of what is needed is obtained, which is relaxation.
How to do a perineal massage in ten steps
To teach you how to practice a perineal massage, you must imagine your perineum as if it were a clock face , 6 o’clock being the lowest area and closest to the anus, and 12 o’clock the highest area and closest to the urethra.
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1) The person who is going to perform the massage must first wash their hands with soap and water and make sure that the nails are clean and well trimmed.
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2) Empty the bladder as a step prior to the massage
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3) Find a comfortable and quiet place. If you like, you can use aromatherapy and relaxing music. It is important that you are as comfortable and relaxed as possible.
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4) Find a position that is comfortable for you to begin the massage. The midwife recommends the semi-lying position, supported by cushions or pillows. But remember that it is your massage and you decide how you feel better.
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5) Lubricate your hands and fingers well before starting. There are brands that offer special oils for perineal massage, but you can also use other oils such as almond or rosehip if you prefer.
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6) Begin by doing an external massage on the perineum . Lubricates the entire vagina, labia majora and, later, the labia minora. This external massage will promote blood circulation.
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7) If you are going to practice the massage yourself, insert the thumbs of both hands about three or four centimeters, without ever reaching the urethra, to avoid the possibility of a urine infection. If it is your partner who performs the massage, you must insert the index and middle fingers.
Begin by massaging the lower area of your vagina and work your way up to both sides drawing a ‘U’. Using the simile of the clock you would start with your fingers at 6 o’clock and with slow movements, but exerting more and more pressure, draw a ‘U’, bringing your fingers to 3 o’clock, going down again at 6 o’clock, going up at 9 and back. to go down at 6. Repeat these movements several times.
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8) Then you should go on to massage in the shape of a half ‘U’ or half moon, that is, from 6 to 9 repeatedly, and then from 6 to 3. The pressure should be increasingly intense and towards the anus, but it should never hurt.
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9) Press at 6 o’clock for 30 seconds. Then press at 7 o’clock for the same period of time. Finish pressing at 5 o’clock for another 30 seconds.
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10) Finally, perform the same movements and the same pressure, but with the variant of exercising the movement towards the anus and outwards.
And to finish, we leave you this video recorded by the midwife Nereida Hernández , from the Mis Matronas team, where she explains very clearly how to practice this massage by following the steps just mentioned.
Photos | iStock
Acknowledgments | Saray Losarcos, midwife of ‘Mis Matronas’, an online preparation platform for the process of pregnancy, pre, postpartum and the baby’s first months. Facebook, Instagram, Vimeo
In Babies and More | How to do perineal massage to reduce the risk of tear and episiotomy
