Massaging the perineum (skin and tissues around the vaginal opening) daily for the last six weeks of pregnancy may help avoid the need for an episiotomy and/or prevent tearing by stretching the vaginal and perineal tissues. Strengthening and learning to relax the pelvic floor muscles by practicing Kegel exercises is also helpful. Below is important information you need to know:
- If you or your partner has a history of herpes, avoid the massage 4 weeks prior to delivery or discuss with your provider.
- The massage should be done daily for 5-10 minutes beginning at 34 weeks ( 6 weeks before your due date). You can do the massage yourself, but many women find it easier for their partner to do it.
- Make sure your bladder is empty and that you are propped up comfortably. Use a mirror the first few times to become familiar with the area you are massaging.
- Massage a natural oil (wheat germ, olive, plain salad oil or vitamin E oil) into the tissues of the perineum and Astroglide or KY Jelly work well too.
- Put your thumbs ( or have your partner put both index fingers) about 2 inches into the vagina and press downward toward the rectum. While maintaining steady pressure, the fingers should be moved upward along the sides of the vagina in rhythmic “U” or “sling” type movement. Be sure to avoid rubbing the urinary opening which is at the top.
- As you massage each day, your tissues should relax and stretch. Gently stretching the vaginal opening as wide as possible each time until you feel a tingling or burning sensation. This will help you recognize the feeling that you will have when your baby’s head begins to crown.
- Hold this stretch, without hurting, for 45-60 seconds and then release. Massage with more oil, stretch again to maximum, hold, then release.
- In the beginning your perineum will feel tight, but with time and practice, the tissue will relax and stretch. If you do the massage faithfully, you/your partner will be able to insert more fingers in the vagina perineum perineum becomes more elastic.
- Do Kegel exercises (tighten the perineal muscles) and feel how strong the muscle is. Feel how difficult the stretching is when you are tensing the muscle of the pelvic floor. Consciously release them as you do the massage. Remember to do Kegel exercises before and after the baby is born to improve muscles strength and tone.
- This massage should not be painful. It will burn and be uncomfortable when you first begin, but will improve with time. If you have any questions or problems, please talk with your provider.