Perineal massage just stretching v opening, not perineum? Advice needed!

[ellieenn]

Hi all, first time mum here, currently 35 weeks pregnant and trying to get to grips with perineal massage. I’m doing it myself (as in, my partner isn’t doing it for me), and all the resources I’ve seen have been very clear that it’s about stretching your perineum - the skin between your vajayjay and butt. However, every time I try to do it, with two thumbs in my v as directed, all I can feel is stretching the bottom of my (internal) v opening, which feels really tight. I can never stretch my perineum because I’d have to first reeeally stretch my v opening to even get down to the perineum, if you see what I mean! It doesn’t seem to involve my perineum in any way. Worse, I’m scared this means my v opening is way too tight for baby to fit through. Am I doing it totally wrong? Pls help!

Saw you had no replies and thought I'd try and help!

I'm not entirely clear what you mean by internal vaginal opening? You're successfully getting both thumbs inside your vagina? (Not always so easy at 35 weeks!!). If not possibly trying to relax more / using more oil / getting a partners help might work.

The perineum is all the skin and muscle between your vaginal opening and anus and it does tend to be quite tight before a first pregnancy - hence how common tears are! So just start small - you don't need to feel like you're reaching all the way in. I think maybe that is what you mean by internal opening? That you feel you need to be reaching past the tight skin at the entrance to some deeper muscle? But that skin is part of the perineum and the bit that most commonly tears (first degree tears upwards) so just start there.

Having said that, there isn't much evidence perineal massage actually works so don't over stress! (Or possibly I'm just terrible at it because I definitely tore anyway... so maybe someone will come along with better advice!)

No better advice, but came to say I didn't feel comfortable doing it at all, so didn't prior to or during either birth, and didn't tear either time even though they were super fast deliveries.
I was also somewhat tight down there so that wasn't a factor either.
I did however use oil on my thighs and belly (which ultimately lubricated all of downstairs after walking to bed after a shower) which may have helped?

I'd imagine trying to do the massage yourself would be quite tricky as you're not able to fully relax your pelvic floor due to positioning and bump and therefore is maybe making it not so effective and feeling tighter than it should necessarily be?
Perhaps try a position that allows for better relaxation, such as a deep squat?

My husband did the perineal massage for me as instructed for the required time but I still ended up with a bad tear because my son came out at a weird angle. Poor lad had a nasty lump on his head as well :(

I wouldn’t worry about it too much. Try your best as it can’t hurt, but there are so many other factors that can contribute to a potential tear which are out of your control.

Thanks @ZippyKoala for your kind reply! I can indeed get both thumbs in properly. The problem is that, if I can share a link (warning NSFW / illustration of vulva anatomy): https://reconstructive-gyn.com/application/files/1915/7910/7645/diagram.jpg - if you see the area immediately below the vaginal opening, the pink area between the inner labia that is above the perineum, that is what I feel I am stretching. I don’t feel any stretch to the perineum, as in the actual skin that’s flesh-coloured in this diagram, because my vaginal opening isn’t wide/stretchy enough to let my thumbs get down there! Will talk to my midwife about it but it’d be so helpful to hear if others felt their actual perineum stretching, or just the vaginal opening…? Sorry, feels weird saying this to strangers!! Thank you again!

That makes sense! So as I understood it, that is part of what you are meant to be stretching. A first degree tear for example, only tears that area of skin. I think as you do it more you are able to stretch more. But your midwife will definitely be best able to advise.