Perineal Massage During Pregnancy
What Is Perineal Massage
Perineal massage is the practice of massaging the perineum during pregnancy with the goal of avoiding perineal trauma (aka tearing) during birth. Pregnant persons are instructed to insert a lubricated finger or two into the vagina and apply gentle downward and sideways pressure for a few minutes at a time. Starting at 34 or 35 weeks, this can be done solo or you may recruit a partner for help. Sweet almond oil was used as lubrication in several of the trials; but feel free to experiment to find what works best for you.
What Does the Evidence Say?
An analysis of four, randomized and controlled trials tells us a number of things. First, it shows that benefits were only observed for individuals birthing for the first time. Secondly, it tells us that while there was a reduction in perineal trauma (a 10% relative reduction in tears requiring stitches and a 16% relative decrease in episiotomies), the effect was too weak to be able to observe any difference in the degree of severity (first, second, third or fourth degree). Finally, the evidence also shows that the less you do the massage, the better the results; actually those that did perineal massage more than 3.5 times per week experienced zero benefit and experienced, on average, a 10 minute increase in their pushing phase of labor.
Bottom Line: Can’t Hurt, Might Help.
The evidence is a bit confusing, to say the least, but what it seems to tell us is that individuals who are motivated to avoid tearing, and would therefore practice perineal massage, are probably equally motivated to avoid episiotomy as well. If you choose to incorporate perineal massage into your pre-birth routine, remember that once a week massage yielded the best results and although there is no consensus on how long is optimal, many participants were instructed to massage for 10 minutes per day.
Our bottom line: do what works best for YOU. If the idea of perineal massage sounds awful, there’s your answer! If you try it and hate it, there’s your answer. If you feel like this could be another tool that you utilize in preparing for #YourBestBirth and you wanna give it a shot, there’s your answer.