How to help protect your perineum during childbirth

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The main benefits of the perineal massage are psychological. It’s great to get your mind understanding that your body is changing. It’s not the same as it was nine months ago. To birth a baby nine months ago wouldn’t be nice, but now, at the end of your pregnancy, your body has changed and adapted to open up easily for your baby to be born. What will protect your perieum while giving birth is the position you birth in. Sitting on your bottom or lying on your back will make your baby’s head push against the perineum rather than sliding infront of it. Being on all fours or in a high squat (so your knees are lower than your waist) will allow baby to slide out without putting pressure on the perineal muscles. Strenuous pushing and holding your breath is a sure way to damage yourself. Babies come out because they extend their neck, lifting their chin and also by the power of your uterus. Once your baby has turned and their shoulders are your pelvic rim, then they can come out. No amount of pushing will make this turning happen and will only exhaust you both. Straining and pushing your baby out will not do the same safe job as your uterus and baby can, so keep breathing and let your body do the work for you.

Procedure
[To be carried out by the pregnant woman or partner]

1. Wash your hands thoroughly and apply a non-irritating lubricant to your finger. I recommend an oil such as olive oil, sweet almond oil, grape seed oil or jojoba oil as these will nourish the muscles as well as help you massage.

2. Place your fingers gently inside your vagina about 1- 1½ inches. Press down towards your anus until you feel a stretching sensation.

3. After about 2 minutes of sustained pressure, slowly, but gently begin pressing your fingers from the midline towards the sides of the vagina in a sweeping motion, while pulling back towards your anus. Continue for two minutes giving these muscles a good stretch.

Use this technique daily from weeks 36 onwards. Before 36 weeks you need your perineum to be tightening and strengthening, so carrying out this procedure before 36 weeks will create the wrong situation as it’s designed to soften and relax the muscles of the pelvis. Start with one finger and build up to two or more.

NB Please make sure that you do not massage the top of the vaginal opening as you may cause an infection in the urethra and bladder. Also do not perform if you have active herpes or other vaginal lesions, if the amniotic sac has ruptured/ your waters have broken or if vulvar haemorrhoids are present.

Helpful hint: Place your finger inside your vagina from behind… you’ll never reach around your belly if you go the front way!

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