The perineum is the area between the vaginal opening and anus.
Studies have found evidence that regular massaging of the perineum towards the end of the pregnancy can reduce the risk of perineal trauma that requires stitches in first time mothers.
This research also identified that the benefits of perineal massage were greatest for women aged over 30 who had not previously given birth.
The better you prepare your perineal tissues for the stretching of birth, the less they will tear and the better they will heal.
You could include perineal massage as part of your preparations for childbirth when you reach 34 weeks of pregnancy.
There is no evidence on how many times you should massage your perineum to reduce tearing during birth, but according to the Cochrane 2014 study the frequency would be 2-3 times per week in primigravida.
- Find a quiet, private place to lie down. Use the pillows to support your back so that you are in a semi-upright position. Play some calm music to feel relaxed.
- Apply oil or lubricant to your fingers, thumbs and perineum.
- Insert two fingers around 3-4 cm deep into your vagina. Gently apply pressure towards your anus. Gently pull your two fingers apart so that your perineum is being stretched both downwards and outwards. This should not hurt, and you should not notice any burning.
- Imagine that your vaginal opening is a clock face. Pull your two fingers down to 6, then stretch them outwards and upwards towards 3, applying pressure. Repeat this 20 or 30 times. Then move the other side and repeat from 6 to 9.
- Stretch the perineum externally. Place two or three fingers from each hand in the centre of your perineum, and stretch the skin outwards towards your thighs.
- Place your fingers in a V in the middle of your perineum and pull upwards towards your vaginal opening.
- Place your thumbs in the middle of your perineum and push them apart in opposite directions.