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Antenatal Perineal Massage

Information for women


Perineal massage has also been shown to reduce perineal pain in the months post birth for women who have had more than one vaginal birth. This natural stretching sometimes results in perineal tears. At times. a small cut called an episiotomy is made in this area. You can talk to your midwife about perineal massage or you can contact the named midwives on the back of the leaflet for more information. What can I Do to Avoid Perineal Tears? Several studies have shown that perineal massage from 35 weeks of pregnancy reduces the likelihood of the need for episiotomy and the incidence of perineal tears that require stitches. when the baby needs to be born quickly or the mother needs assistance. How Often Do Perineal Tears Occur? It is estimated that 85% of all women who give birth vaginally will tear. About two thirds of these women will need stitches. Vagina Perineal 1 . during the birth. What is the perineum? The perineum is the area of skin and muscle between your vagina and anus. The perineum naturally stretches. This leaflet explains why this could be helpful and gives instructions on how to perform this exercise. to allow your baby’s head and body to be born.Perineal massage during pregnancy helps to gradually soften and stretch the vagina and the perineum in preparation for birth.

ready for birth. • It helps you know your body and prepares you for the feeling of pressure and stretching that you may feel as your baby’s head is being born. How do I do it? The first few times. or standing with one foot raised and resting on the bath. make sure your bladder is empty. It is entirely up to you.What are the benefits of Perineal Massage for me? The evidence suggests that women having their first baby. toilet or a chair. Reasons why you should consider Perineal Massage! • It helps to gradually soften and stretch the perineum. It is probably more comfortable to do the massage after a bath. women 30 years and older and women who have had episiotomies before can particularly benefit from perineal massage. You can do the massage in several positions. squatting against a wall. This will help you relax and take active part in the birth of your child • It can promote closeness between you and your partner. take a mirror and look at your perineum. Perineal massage can also be beneficial to women who are planning a first vaginal birth after caesarean (VBAC) Who does the Massage? You or your Partner can do the massage. When should I start and how Often should I Massage? It is recommended that you start massaging any time from 35 weeks of pregnancy and massage 3-4 times a week for at least 5 minutes each time. as the warmth of the water can help soften the surrounding tissues. Wash your hands before beginning. Urinary opening 2 . and position yourself comfortably. semi-sitting.

This is a good time to practice slow. Should you find it so. This will help you become familiar with the sensation that you will experience when the widest part of your baby’s head begins to stretch you . d) You can also massage the skin of the perineum between the thumbs and forefingers. 3. Use more oil if required to reduce friction 5. sweet almond or sunflower oil. it is probably easiest to use your thumbs. 2. b) Using your two thumbs press downwards in the direction of your anus so that you feel a stretch of the muscles surrounding the vagina and the vaginal tissues. As you or your partner perform the massage. a) Place the fingers or thumbs about 2 inches (5 cm] into the vagina (up to the second knuckle). If you are doing the massage yourself. Otherwise your partner can use both index fingers.1. mineral oil. If you are sensitive to any of these. In the beginning your perineum may feel tight. This massage should not be painful. Lubricate your fingers well. use your thumbs to sweep from side to side in a rhythmic U shape movement. (it is advisable to use unscented organic based oil like. olive. Once you have this downward pressure. apply steady pressure downwards towards the back passage. You can also use your body’s natural vaginal lubricant. deep breathing techniques. 4. You need enough to allow your fingers to move smoothly over the perineum and lower vaginal wall. until you feel a tingling sensation. 6. c) Concentrate on relaxing your muscles. you can use a water soluble jelly such as KY gel. or petroleum jelly. stop and start again 3 . but with time and practice the tissues will relax and stretch. Do not use baby oil. Produced by: Millicent Engmann (RM) and Teresa Arias (RM). downward pressure method should be used. The same side-to-side. No.1002/14651858. Issue 1. However.: CD005123. However. Cochrane Database of Systematic Reviews 2006.pub2 For further information.Partners If your partner is performing the perineal massage. your partner should use their index fingers to do the massage (instead of thumbs). Art. Are there any risks of perineal massage? There are no known risks of perineal massage. Further Reading: Beckmann MM. do not perform perineal massage if you think your waters might have broken or if you are suffering from vaginal infections such as Thrush or Herpes. Garrett AJ (2006) Antenatal perineal massage for reducing perineal trauma. please contact: Consultant Midwife Teresa Arias: 020 3299 1491 Staff Midwife: Millicent Engmann: mengmann@nhs. 4 . please contact your midwife. Good communication is important—be sure to tell your partner if you have too much pain or burning! What if I can’t do it? Women have different experiences before becoming pregnant. follow the same basic instructions as above. If you feel distressed or frightened and would like to discuss it further. U-shaped. Please contact your midwife in these circumstances. OI:10.

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