How to Do Perineal Massage

A perineal massage should prepare the tissue between vagina and anus for the birth and protect it from the much feared perineal tear. And this is how a perineal massage works.

Where is it located?

The perineum is the area between vagina and anus. During birth, this tissue is subjected to great pressure and stretching – the baby eventually creates the space it needs. However, you can try to prepare exactly this area for the birth with a special massage technique during pregnancy to prevent a perineal tear.

Nevertheless, perineal massage is unfortunately no guarantee that birth injuries such as perineal tears will not occur.

Therefore a perineal massage is still useful:

1. The perineal massage makes the perineum softer, better supplied with blood and more elastic.
2. You get to know your body even better and get a feeling for stretching. You can prepare yourself physically and mentally for the birth and this may take away your fear of it. The more relaxed you are during the birth, the more positive the effect on the birth process. Especially in the pressing phase you can let go more easily.

When should I start with the perineal massage?

Midwives recommend that perineal massages be performed three to four times a week for about five to ten minutes from the 34th week of pregnancy onwards. But if you can’t manage to do it quite as regularly, every single time already helps to prepare your perineum and yourself for the birth during pregnancy.

How do I prepare for the perineal massage

• Very important: Clean hands and short fingernails
• Take your time! Maybe you will enjoy a nice bath beforehand, then the tissue will be softer and better supplied with blood. Or you listen to your favourite music. The main thing is that you are as relaxed as possible and feel good. Therefore, please do not perform quickly between door and hinge. If the next appointment is already coming up, you may not be able to relax sufficiently.
• For the massage, choose an oil that is pleasant for you, for example almond oil, wheat germ oil or jojoba oil. There are also special perineal massage oils, for example from Weleda or Motherlove.

Perineal massage: That’s how it’s done

1. Make yourself comfortable in a semi-seated position with a cushion in your back. If you can reach the perineum better standing up, of course you can. Many women put one leg on the toilet or the edge of the bathtub.
2. Now you put enough oil on your fingertips and rub it a little bit, so you warm up the oil a little bit.
3. Then you insert your thumb into the vagina while your index finger massages the perineum from the outside. The best way to do this is to imagine a clock on whose dial you stroke back and forth between three and nine o’clock.
4. Perform small, circular movements. This way you loosen the area of the lower vaginal walls.
5. Next, try stretching your vagina towards the vaginal wall, towards six o’clock. To do this, first take one finger, then two, and then try to spread them even further. But only so far that it does not cause any pain.

Tip: For the first attempts it can be helpful to have a mirror at hand.

Important! Of course, you don’t have to do anything that makes you totally uncomfortable or causes pain. If you are unsure or have questions about the perineal massage, you can always contact your midwife.

However, if you would like to try out the perineal massage, you will notice from time to time that your tissue and muscles loosen more and more and you will also gradually get used to the feeling of stretching.
Of course you can also let your partner do the perineal massage if you want to or if you have difficulty getting at it yourself during your pregnancy.

When would you rather give up the perineal massage?

1. If you are prone to premature contractions, you should refrain from perineal massage or, after consultation with your midwife, not start until the 36th week of pregnancy.
2. In case of fungal infections that occur more often during pregnancy, please treat them first and then start with the perineal massage.

Many women find the perineal massage disconcerting at the beginning and may also have some fear of contact. However, if you are open-minded enough to get involved, this massage can be experienced as very pleasant. It is definitely good for you before the birth and in the best case it also protects you from a ruptured perineum.