Can Perineal Massage Help You Avoid the Episiotomy?


Labor is a very painful and intense ordeal. The duration of this experience depends a lot on the strength of the contractions, the size of the baby, and the anatomy of the birth canal. The perineum is the area of the body between the anus and the vulva.

Labor is a very painful and intense ordeal. The duration of this experience depends a lot on the strength of the contractions, the size of the baby, and the anatomy of the birth canal. The perineum is the area of the body between the anus and the vulva. You should rub or knead the muscles in order to relieve muscle tension. Perineal massage consists in rubbing or kneading the perineal muscles of a pregnant woman in the last couple of weeks of pregnancy.


This is in order to allow these muscles and the surrounding tissue of the birth canal to stretch and relax prior delivery so an episiotomy can be avoided. When the canal birth is too narrow and when the baby is putting too much pressure on this area during childbirth, an episiotomy is required. An episiotomy is a cutting of the muscular area, commonly known as the perineum in order to help enlarge the vaginal opening during childbirth.

This area is exactly located between the vagina and the anus. It is normally done when the perineum is too rigid and too tight to allow a normal and easy delivery. It is also done to prevent tearing of the perineal wall as the baby tries to pass through the birth canal. It is also performed in order to allow a fast delivery of the baby. An episiotomy is seen as a necessary evil because, despite the practical reasons for doing it, it leads to some extra pain and discomfort after birth.

This can last up to a couple of days or a couple of weeks. It also changes the structure of the perineum permanently, as most of the muscles get replaced by a scar tissue. To reduce the possibility of an episiotomy, or a perineal tear, several practices have been tried over the years, and perineal massage is one of those. Perineal massage has a long and rich history, with the Chukchi Eskimos in Siberia using glass bottles and African tribes using gourds.


This is in order to increase the size of the vaginal canal and to increase the elasticity of the perineal area. The beautiful thing about a perineal massage is that it is relatively easy to perform. It does not require any special equipment, and you or your partner can do it in the absence of any medical professional. The massage is preferably done after taking a bath. You will need to take a comfortable position, wash your hands and lubricate your thumb with a water-based lubricant.

You can choose natural lubricants like olive oil or almond oil if you prefer. Once the hands are cleaned and lubricated, you need to place the thumb inside the vagina. The thumb should be inserted until the first knuckle of it is at the same level with the mouth of the vagina. This means that about 1-1.5 inches of your thumb would be inserted into the vagina. With the thumbs still in the vagina, push downwards towards the direction of the anus, and outwards towards the sides.

Keep pushing till you feel a burning and a stretching sensation. Hold your thumbs in place at this point for a minute or two. After that move your thumbs in around the lower half of the vagina by moving in a “U” shape from side to side for about 10 minutes. That way you will massage the side walls and the base of the vagina as well. Like massages on every other part of the body, it is not a one-time procedure, but should be done repeatedly.

Some experts recommend 6-10 sessions starting from 4-6 weeks before expected due date and continuing until the child is born. Interestingly, the upper half of the vagina does not need to be massaged, as it is surrounded by bones. The urethra is also found in this area, and any attempt to massage it may lead to some level of discomfort and even urinary tract infections.

You will want to avoid the upper half of the vagina during the perineal massage as you won’t have any profit from it. Women have reported an increase in the width of their birth canal with each session of perineal massage. Certain researchers have also been conducted in order to show the effectiveness of the perineal massage in preventing perineal tears and episiotomy during delivery.

One of such research's in the UK noted that there was a 6.1% reduction in second and third - degree tears. And there were episiotomies in women who did perineal massage during the last month of their pregnancy. The effects were higher in women over the age of 30 years old who were having their first baby. This is probably because of the fact that older women normally have a more rigid perineum compared to women at their 20’s.

The perineal massage helps widen the birth canal and make its walls more elastic and less likely to tear. In younger women who were having their first babies, the effect on their still elastic perineum is minimal. For women who have had previous episiotomies and women who had perineal tears in their previous pregnancies, perineal massage does not have much effect. This is due to the fact that the scar tissue is already formed by the previous damage to the perineum.

Normally, this scar tissue is not that strong as the muscle is. Therefore, despite the massage, there is a minimal change in the width of their birth canal. However, these women can still need an episiotomy during the childbirth. Despite the effectiveness of the perineal massage, there are some people who it is not recommended for. These include women who have had preterm labor, premature rupture of the membranes in the past, or currently have a vaginal infection.

It is also wise to stop perineal massage if it causes discomfort or stimulates contraction. Whether or not you decide to try the perineal massage, it is very important that you keep your appointments with your obstetrician. No amount of personal research can replace the competence of a skilled physician.


Article last time updated on 05.12.2017.

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