Perineal massage - what to do???

[Gingerhan]

Hi,

I have heard lots about the benefits of perineal massage, but am really flummoxed by the various instructions that I have found on the internet!
I don't have a clue what to do - can anyone give me any advice so that I don't pummel away with no effect?!

If it doesn't hurt, you're probably not doing it right! Ask your midwife/ antenatal teacher for advice - it makes much more sense when shown (though I don't mean actually get her to demonstrate on you, just hand gestures!!)

Can you get your DP to do it for you? Not everyone can! I do and he's very good at it. It's a bit like leg waxing - hard to willingly inflict the pain on yourself - and it should hurt a bit. Not loads, but it should sting.

There are various ways: one is to insert two thumbs and move them round in semi cirlces, pressing low down on the perineum, slightly stretching out to the sides as you go - press until you "feel the burn" then hold for a few seconds - eventually the area will start to numb a little and you'll be able to tolerate a bit more.

Another is to insert the thumbs and press down with both, then drag slowly out, pressing down all the time.

It's not fun. But it's a good time to practice your breathing and also to practice some pelvic floors (squuezing around the thumbs you can really tell if you're doing them properly). My DH says it feels a bit stretchier now than when we started.

This is my first time so I've no idea what "ring of fire" is but I imagine it feels something like the sensation this gives me so hopefully I won't be quite so shocked by it.

Good luck

OMG, I am actually a little shocked.

I am first timer and 16 weeks and I thought all you had to do gentley massage the area between vagina and anus which is always what I have thought was the perineum. Not doubting what you are saying just very shocked.

Me too hippopo!!

What the....... ??!!

Me too hippopo!!

What the....... ??!!

Would highly recommend it,my dh did it for me & my dd2(7.7)was born with no cuts/tears at all.

I was told only 2-3% people tear anyway??

And where are your thumbs being inserted ??!

Nope - it really does work i did it with my Ds - 8lb 2 and no tears. and this time i have discussed it with my MW and she says there are actual studies that support the benefits.

i agreee its sound awful but lots of things about pregnancy / childbirth do tbh and its well worth trying.

Haha, at first i assumed it was just a massage between both bits.. when i saw actual instructions i was a bit put off but im still definitely gonna do it. I want to try and remain as intact as possible!! Does anyone know if you really have to wait till around 34 weeks (i cant remember where i got that info from but its stuck in my brain) or can you do it earlier? Im only 29 weeks but want to be as prepared as possible! My fiance keeps on about trying it...which i find slightly worrying!

Your thumbs (or your partners-which is easier)are inserted just inside the entrance of your vagina,then circling round,but pushing down and stretching the skin at the bottom(near towards your anus),use some oil (unperfumed)for lubrication.It is quite uncomfortable,we did it 2/3 times a week from about the 35th week,just for a few minutes at a time.
I am sure it helped me,as I didn't do it with dd1,she was 5lb 12oz & had to have an episiotomy,which was awful,so I know what I'd prefer to do!!

I also had vague thoughts it involved gentle massage of the external area when I was in

Anyway, am now 34 weeks and started it yesterday, using olive oil. I've found this NHS guide invaluable - warning: it includes a fairly graphic illustration of what to do!

Glitterkitten the NHS guide I linked to quotes a study that estimates that 85% of women suffer some degree of tearing. Which is why I decided it was worth a go!

I never did anything like this, and I've pushed 2 children out with no tears or stitches or anything!!

When I was pregnant my midwife told me to put some lavender oil in my bath from 34 weeks to soften the area.

I had never heard of perineal massage until I joined MN!

just to add as well - I used baby oil instead, couldn't find lavender oil for love nor money!!

I am dashing out at the moment so excuse the haste here. I teach PM and I can totally assure you that it should not hurt, sting, feel sore, or burn! Use your outgoing breath. Gently send it to the space behind your fingers and as you relax as you breathe out, ask the back wall of your vagina to relax too. Often it takes a while, abit like blowing up a balloon!, before the perineum begins to softly pre stretch. If you dont like doing PM then use the experience to inform you where you need to relax when birthing your baby; also you can sense how painful it is to try and stretch that area without relaxing, and that will help you relax during the birth. Hope this helps. DO NOT GO INTO PAIN!!!

santosh when should you start doing pm? so from ive read above and i think i've got this right! The basis is... you massage in semicircles with your thumb inside the entrace your vagina and push down and carry on to the skin inbetween there and anus and maybe use some lubrication? What kind of lube? Is there an oil which would help further?
sorry to sound dumb but i want to get this right.

kaylohalo will definitely be doing the lavender oil in bath too.

Really recommended at ante-natal classes when I had DS1 - hated doing it but persevered. I used vitamin E cream because I had some. No stitches needed for any of my 3 DCs.

santosh I didn't mean it should hurt a lot but I'm afraid everything I have read on this and heard anecdotally says that it will sting a bit. Maybe some people are more sensitive in that area than others, less used to it being touched/stretched. Maybe it's not a painful feeling but definitely can be uncomfortable at first. Possibly it's just the newness of the sensations that we interpret as pain. Either way, insisting it doesn't hurt might put some people off doing it if they experience discomfort.

It's a bit like breatsfeeding experts saying bfing shouldn't hurt. A lot of women stop precisely because it hurts and they assume there's a problem. When actually, most women will tell you it can be very uncomfortable at first, but that it passes.

Ladies, I am using olive oil, if that helps. And I definitely feel it's doing something as each time we do it, it feels more comfortable.

I'm 24 weeks - is it too early to start PM? Does it shrink back to normal afterwards (this is my first time.....)

24 wks is too early. I think you're ok to start from 34/35 wks. As for does it shrink back(!!) it doesn't actually stretch visibly or in any way that you are aware of it just makes it all a bit more flexible I suppose. Prepares it for being stretched more easily in childbirth.

I have cut and pasted the following from the Babyworld website...

What are the benefits?

Perineal massage has many benefits which all help to reduce trauma during birth.

It stimulates the blood supply to the perineum and helps speed the healing process after the birth.

It helps prepare you for the feeling of pressure and stretching that comes as your baby's head is born.

It helps to familiarise you with some of the sensations such as tingling or burning so you are less likely to tense up.

It can help you to relax when you have a vaginal examination.

Midwife Tania Pearce to provide expectant parents with a more personal approach to antenatal and post natal education, including the benefits of perineal massage. She says, "From my experiences as a midwife I have noticed that women who have done perineal massage are more likely to have perineums that stretch well around the baby's head.

"These women also have more control over the expulsion of the baby's head, and allow it to be born slowly. "Because they are use to the sensations they are experiencing they are not frightened of them and don't rush the birth.

Worth a shot!

I did PM with DS1 and will be doing it again once I'm 34 wks (currently 28 wks pg with DS2) as I had a natural birth with no tears, cuts or episiotomy last time and DS1 was 8lb 1oz.

I followed the instructions in Dr Gowri Motha's 'The Gentle Birth Method' - get it from the library. It didn't hurt, just did it every day after the bath using olive oil to stretch the area (pushing back and to both sides, not the front, of the outer bit of the vagina, with thumbs) and found it really helped.

I got DP to do it from 34 weeks, DS was 8lb 15.5 oz, born at 40+1 and I had 2nd degree tear and episiotomy - so it doesn't always work! (and we had detailed instructions from our ante natal class teacher on how to do it!!)

sorry, got DP to do it to me from 34 weeks - to himself would be a bit useless

I think I did "Perineal massage for dummies" but it seemed to work! Much like Snowtiger's advice - Nothing too complicated. Just a touch of almond oil/ olive oil on finger or thumb (whichever you can reach best with - never easy with a bump in the way). - Stick it a small way into vagina and basically just push back towards anus and to the sides, hold for a couple of secs or so and repeated for as long as you can be bothered (no more than a couple of minutes a night in my case) I'm sure all this business of semicircles is good too but I didn't. Seem to remember I pulled some pretty unusual poses when trying to get in a good position to perform this task!

perineal massage is the secret wonder of the birthing world! two births and no tears or cuts - i cannot understand why the practice is not not more encouraged by NHS - my NHS midwife team never mentioned it - only private midwife.

please please do it - you could use olive oil or a natural massage oil, and remember however much - or little - you do, its all helping to prepare your body for birth.

good luck xx