How to do the perineal massage to get ready for birth.

THE BIG DAY IS ALMOST HERE! Do you know how to do the perineal massage? Get ready for your baby’s birth with this easy technique. The perineal massage will help you to prepare your pelvic floor for the day of the delivery.

One of the most studied techniques of manual therapy is perineal massage.

There are plenty of videos around the internet explaining how to perform this manual technique. I always recommend using the “clock technique”. With this technique, you focus on the area of the perineum equivalent to the 7-6-5 of a clock. Anyways, it is more recommendable to visit an expert to be sure about what’s better for you. Your OB-Gyne and your midwife can explain you how to do the perineal massage. Also, physiotherapists specialized in women’s health or pelvic floor rehabilitation.

The perineal massage is an easy and costless tool that will avoid risks during birth.

You just need to wash your hands to start practising! It’s always better to start on your own. This will increase the elasticity of the perineal area and your self-consciousness. If you never practised by your own the day of the birth it will be more difficult to have a clear picture of what’s going on inside your vagina! If instead you are used to touching and stretching this area the day of the labour you will be more able to control de relaxation of the muscles of the pelvic floor.

It’s recommendable to cut your nails and feel free to use gloves free of talcum powder it this seems more comfortable for you.

Over the years perineal massage has become very popular. It’s scientifically proven to reduce the risk of pelvic floor tear and episiotomy.

There is plenty of brands of oils and ointments to do perineal massage. Remember to avoid those with alcohol or perfumes that are not essential oils. Some women have allergies to substances that are “natural and organic” … So don’t try a big amount of product the first time that you use it! Stop immediately the application of the product if you develop any itchy or burning sensation. Anyways, during pregnancy is normal to have more discharge so usually you won’t need any product.

In order to prepare the area you can apply for a couple of minutes a warm compress over the vulva. This procedure softens the tissue and increases the blood flow. You can start externally. The perineal massage should give elasticity to the superficial perineal muscles and not only to the internal muscles of the pelvic floor. To relax the external part you can apply pressure with your index and middle finger in the laterals of the vulva. The pressure should never be painful.

Once you are ready to go inside, the best option is to use your thumbs.

Imagine that the entrance of your vagina is a clock. At the lower part, you have the numbers 5, 6 and 7.  Stretch those points until you feel a slight discomfort. Then keep the pressure until the discomfort fades away and then try to advance gently.

Did you notice that I haven’t told you when to start doing this? This will depend of how are your pelvic floor muscles doing. Some women have a lot of tension and need to start before week 30th to do the perineal massage. Women who had an episiotomy in previous deliveries may need to start sooner too..

If you have pain during intercourse, a previous scar, constipation or pelvic pain PAY ATTENTION. It will be interesting to visit a pelvic floor specialist in case you should start practising the perineal massage sooner.

Women with a very elastic pelvic floor should start later to do the perineal massage and even avoid it. If you have varicose veins, swelling, incontinence or prolapse is better to double-check. Your pelvic floor specialist will recommend when to start or will adapt the techniques for you!

Increase the intensity and the frequency of the perineal massage progressively. Always double-check with your OBGYNE about the convenience of this technique in your specific situation. There are not many contraindications for perineal massage. Just check first with your gynaecologist or contact here to receive more information.

You can also download the step-by-step instructions.

In summary, remember these tips :

1. Use a warm compress to relax the area

2. Stretch your perineum imagining that the entrance of the vagina is a clock, and focus on the 5-6-7.

3. Use a specific product for perineal massage, avoid products with perfume or just let your body create lubrication by itself

4. The perineal massage is a tool to relax. You need to be focused on relaxation and the process should not be painful.

5. Always get the approval of your medical provider

6. Check with a physio specialized in PELVIC FLOOR if you have doubts or if something feels weird.

If you want to visualize better how to do the perineal massage, visit this post on Instagram to check out the video about the clock technique.

Marina Vecino Pérez

Physiotherapist specialized in pelvic floor rehabilitation