Excerpt from The Birth Book By William and Martha Sears

pregnancy photo and ultrasound The better you prepare your perineal tissues for the stretching of birth, the less they will tear, and the better they will heal. Like training muscles to perform at their best in an athletic event, conditioning the tissues around the vaginal opening with massage prepares the perineum to perform. Midwives report that women who practice perineal massage daily in the last six weeks of pregnancy experience less stinging sensation during crowning. Mothers with a more conditioned perineum are less likely to tear or get an episiotomy. An added value of perineal massage is that it familiarizes a woman with stretching sensations in this area so she will more easily relax these stretching muscles when stinging occurs just before the moment of birth.

Try this technique:

  • Scrub your hands and trim your thumb nails. Sit in a warm comfortable area, spreading your legs apart in a semi-sitting birthing position. To become familiar with your perineal area use a mirror for the first few massages (a floor-to-ceiling mirror works best). Use massage oil, such as pure vegetable oil, or a water-soluble lubricant, such as K-Y Jelly (not a petroleum-based oil) on your fingers and thumbs and around your perineum.
  • Insert your thumbs as deeply as you can inside your vagina and spread your legs. Press the perineal area down toward the rectum and toward the sides. Gently continue to stretch this opening until you feel a slight burn or tingling.
  • Hold this stretch until the tingling subsides and gently massage the lower part of the vaginal canal back and forth.
  • While massaging, hook your thumbs onto the sides of the vaginal canal and gently pull these tissues forward, as your baby's head will do during delivery.
  • Finally, massage the tissues between the thumb and forefinger back and forth for about a minute.
  • Being too vigorous could cause bruising or swelling in these sensitive tissues. During the massage avoid pressure on the urethra as this could induce irritation or infection.
  • As you become adept with this procedure, add Kegel exercises to your routine to help you get the feel for your pelvic muscles. Do this ritual daily beginning around week 34 of pregnancy.
  • Many midwives and obstetricians believe that perineal massage is neither useful nor necessary as long as the mother's perineum is supported during crowning, her pushing is properly timed, and the baby's head and shoulders are eased out. Discuss the value of perineal massage with your birth attendant.

Research on Prenatal Perineal Massage