Does perineal massage work?
When the baby’s head passes through during birth, the tissue of the vagina, pelvic floor and perineum is stretched as much as possible, which can lead to tears. The perineum is most at risk – perineal tears are therefore a common birth injury. Sometimes an episiotomy is performed during the birth as a precautionary measure to relieve the tissue.
A regular perineal massage before the birth should prepare the tissue between the vagina and anus for the enormous stretching during the birth. This should reduce the likelihood of a perineal tear or an episiotomy.
To date, there is little scientific evidence for the effectiveness of perineal massage. According to an Israeli study, the effectiveness is low and not statistically proven. A US study found only a small to moderate benefit for first-time mothers.
Perineal massage: instructions
Before starting the perineum massage, a warm bath can help to relax and loosen the muscles. You can also steep a bag of black tea in water for four minutes and then, lightly squeezed, press it against the perineum for five minutes. Like the warm bath, the heat promotes blood circulation and the tannins contained in the tea make the skin less sensitive to pain.
To avoid irritation of the skin and mucous membranes, you should use a neutral oil for the massage, for example almond, wheat germ or jojoba oil, sunflower, olive or St. John’s wort oil. Or you can get a special perineum massage oil. However, a simple lubricant is just as helpful. Rub the oil or gel between your fingertips to warm it up and then spread it over the perineum and labia minora. Use your thumb to massage along the inside of the perineum and labia and gently press the tissue towards the anus and down the sides – just as the baby’s head presses against it from the inside during birth. Use your index finger to massage the perineum from the outside in small circular movements.
Use one or more fingers to stretch the vaginal opening for about two minutes until you feel a burning sensation and then continue to massage the perineum and labia. If previous births have caused injury in this area and left scar tissue, you should also massage this to soften it.
Your midwife or gynecologist can give you further instructions on perineal massage.
Perineal massage: When and how often?
Perform the perineal massage once or twice a week, unless you have vaginal varicose veins, inflammation or infections in the vaginal area. More frequent massages appear to reduce the effectiveness of perineal massage in an Israeli study.
Perineal massage: better relaxation during childbirth
A perineal massage is no guarantee that the perineum will not tear during childbirth or that an episiotomy will not be necessary. However, it is a good way of softening the tissue and increasing its elasticity. In addition, a daily perineal massage increases your feeling for the vagina and pelvic floor and therefore also your ability to relax during the birth.
