Where is the Perineum?
You might not know where the perineum is – lots of women we talk to don’t know either so you’re not on your own there! Your perineum is the area of skin and underlying muscles that run between your vaginal opening and your back passage (anus). It is this area that stretches as baby’s head is born and similarly it is this area that tends to tear or will be cut during birth if the situation dictates.
How do I Perform Perineal Massage?
The first thing is to make sure you (or your partner) have clean hands and short fingernails, that you have emptied your bladder and are relaxed in a place where you won’t be disturbed. Some women find a mirror handy to help visualise the area, whilst incorporating it into the bedtime routine after a bath or shower is also popular as it brings warmth to the tissues surrounding the area which helps the process. Positioning can be how you feel you’re most comfortable; semi –sitting, one foot up on the toilet, bath or stool, squatting against a wall.
Next place 1-2 drops of Down Below massage oil onto your fingers (forefingers & middle fingers) and apply to the outside of your perineum. Place your thumbs about 2 inches (5 cm] into your vagina.
Press downwards with your thumbs in the direction of your anus so that you can feel the stretch of the muscles surrounding the vagina and the vaginal tissues. Once you have this downward pressure, use your thumbs to sweep from side to side in a rhythmic “U” shape/hammock movement. Whilst massaging the perineum from the outside with your other fingers. When massaging, apply steady pressure towards the anus. This may tingle, but should not hurt! This will also help you to recognise the sensation that you experience when your baby’s head begins to crown.
Focus on relaxing your pelvic floor muscles as you massage, you will notice a difference in how it feels inside, it’s really useful to have an understanding of this when it comes to giving birth because a tense pelvic floor will in a sense fight against you trying to push the baby out!
The perineum will possibly feel tight when you first start, but in time you will begin to feel a change as the tissues relax and stretch; remember this should not hurt! If your partner is performing the massage, just follow the same instructions but ask them to use their index fingers using the same “U” shape/ hammock motion. It is important to tell your partner how much pressure to apply.
All Midwives know about perineal massage and most will talk to you about it towards the end of your pregnancy so if you’re still unsure if it’s right for you check with your midwife!