A perineal massage before the birth can help to prevent a perineal tear. You can read what our midwife Katharina thinks here.
During a spontaneous labour, the tissue between the anus and vagina (the 'perineum') may tear or have to be cut open by the midwife. While the baby is being born, there is enormous pressure on the perineum, which puts a lot of strain on the tissue. Even before the birth, you can loosen the tissue by massaging the perineum and perhaps prevent a perineal tear or perineal incision. We explain how to do this, what you need to look out for and why our midwife Katharina advises caution.
Why do I need a perineal massage?
As already mentioned, enormous pressure is exerted on the perineum during labour, which can cause it to tear. If it does not tear on its own and the midwife sees that the baby needs to come faster than your tissue stretches, she will perform an episiotomy. The purpose of all this is to ensure that your baby can be born. Nowadays, however, episiotomies are only performed in extreme emergencies, as tears heal much better than incisions.
When does a perineal massage make sense?
With a regular perineal massage from the 36th week of pregnancy, you can loosen the tissue and thus prevent a perineal tear or episiotomy. You can also start the massage beforehand, which will help you to find out whether you want to do it yourself or whether someone should help you. It's best to start slowly once a week for a few seconds. You can build up until you manage to do the perineal massage every two to three days for a maximum of ten minutes.
How exactly does a perineal massage work?
So that you can slowly get used to the feeling of the perineum massage, create a relaxed atmosphere and make sure you are calm. To avoid hurting yourself, it is important that you make sure your fingernails are short. Wash your hands thoroughly with warm water and soap, as the genital area can be very sensitive during pregnancy. You may even have time to take a relaxing bath beforehand. Simply try to incorporate the perineal massage into your daily routine as a kind of "feel-good ritual".
Now you need to find a position that is comfortable for you. Some women like to perform the perineum massage standing up, others prefer to sit on the floor. If it is comfortable for you, lean against the wall with a cushion. If you like, you can take a small mirror with you beforehand and look for your perineum. Many women find it easier to massage their perineum later on if they know exactly where it is (between the vagina and anus).
Which oils can I use for a perineal massage?
To ensure that the massage feels good and that the tissue really becomes softer and more elastic, you should definitely use an oil for the perineal massage. Our midwife Katharina recommends the Massage oil from Weleda*which is especially suitable for this purpose. Spread a few drops of the oil on your thumb and index finger and warm it up by rubbing it in. Once the oil is at the right temperature for you, insert your thumb into the vagina and massage the perineum from the outside with your index finger. The circular movements loosen the tissue, which should prevent the perineum from tearing.
Many women find it difficult to perform a perineal massage correctly despite instructions and a mirror. Just imagine a clock:
Your thumb is the hour hand. In the first step of the perineum massage, move your thumb carefully and slowly back and forth between three o'clock and nine o'clock. If this works well, carefully stretch the area at six o'clock. Our midwife Katharina has a tip for you:
"Perineal massage should improve the blood supply to the tissue. Then it can stretch well under the head with the hormones of the birth. The perineum should not stretch before the birth. After all, it has to carry the baby. You should therefore not hurt yourself during the massage, stretch, pull or even tug unnecessarily. Don't forget: your perineum is part of your sensitive genital area. You should treat this area of your body with care and caution"
Who can perform the perineal massage?
If you don't want to do the perineum massage yourself, your partner can also do it. There's nothing to stop you from treating the perineum massage as foreplay. As long as you feel comfortable and are not in pain, your partner can also help if he and you enjoy it.
When should I not do a perineal massage?
Before you even start massaging your perineum, please talk to your midwife or gynaecologist. In some cases, you should not do a massage for the sake of your baby. This applies, for example, if you are in premature labour. You should also refrain from massaging the perineum if you have an infection in the genital area or a bladder infection.
I have pain during the perineal massage: what can I do?
Massaging the perineum is not particularly pleasant for many women. If you experience pain, you should stop immediately. As our midwife Katharina has already mentioned, birth preparation is all about making you feel comfortable and as relaxed as possible during labour. Pain has no place in labour preparation.
Would you like to take a birth preparation course but can't find a midwife in your city? Click here for the Online birth preparation course from midwife Katharina.
One Response
Hi Katharina, thanks for the great article. The massage for mums-to-be is quite good. What would be very important, the doctor should say exactly whether the pregnant women can use it. Thank you, best regards