Starting around 34 weeks, try massaging your perineum. Daily perineal massage may increase the area’s ability to stretch, leading to less need for an episiotomy and fewer natural tears.
Try this technique yourself, with clean hands and trimmed nails.
How to do Perineal Massage
- . Use a lubricant such as olive oil/sweet almond oil to your hands and the perineal area.
- Place a thumb or two fingers 3cm into the vagina (half your thumb).
- Massage the area by gently rubbing the perineal tissues between your thumb and fingers.
- Press downwards and to the sides, gently stretching until you feel a tingling sensation. The feeling lessens after a few moments.
- Once this sensation is felt, hold the stretch for around one minute, until the feeling subsides and begin gently massaging the lower part of the vagina by moving your thumb back and forth. While massaging also hook your thumb onto the sides of the vagina and gently pull these tissues forward, as your baby’s head does, when they are being born.
- Continue to gently rub as you stretch for around 3-4 minutes.
Discontinue if you feel pain.
- Perineal massage alone is not the only technique to prevent tearing/avoiding an episiotomy during birth. Also try:
Pelvic floor exercises
- Squatting, or a similar position that works with gravity, during labour/birth
- Birthing pool – the warmth and water softens the perineum
- Slow births, gently breathing the baby down, rather than coached pushing
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