PERINEAL MASSAGE GUIDE
FOR PRENATAL AND POSTPARTUM SUPPORT
By Megan Vickers, Women’s Health Physiotherapist
Prenatally, perineal massage prepares the soft tissue around your birth canal for the birth of your baby; it can shorten the second stage of labour and help prevent tears. We recommend beginning perineal massage at 34 weeks, performing it 2 to 3 times per week up until labour.
Postpartum, perineal massage supports the healing of tears and episiotomy scars. To repair wounds, your body generates scar tissue which is comprised of irregular lines of collagen and fibrin that don’t stretch easily. With activities such as intercourse, this new tissue can feel like it is tearing when in fact it is just stretching. Postpartum perineal massage encourages elasticity in the scar tissue, easing pain and discomfort. We suggest perineal massage begin at 6 weeks postpartum, and be done 2 to 3 times per week until the tissues have healed and softened.
PERINEAL MASSAGE METHOD
You can massage yourself or invite your partner to massage you. Begin by situating yourself in a comfortable position that naturally opens and stretches your perineum (your perineum is situated between your vaginal opening and your anus). For example, one foot on the side of the bathtub, or on the floor or bed with your legs splayed.
For a more sumptuous massage, warm the oil before you begin by running the closed bottle under hot water.
Moisturise & Prepare the Tissues
Apply a few drops of the Prepare/Repair Elixir to your fingers and gently massage the oil into your perineum, vaginal vestibule and labia, coating and moisturising the tissues. This lubricating massage prepares your tissues for the stretching activities to follow. Rub gently, lovingly and with care, attuning to your body. Do only what feels good to you. Pay special attention to the opening of the vagina (the vestibule) where it meets the perineum.
Insert one finger or thumb into your vaginal opening—just up to the first knuckle. Press directly backwards (towards your rectum) until you feel a strong stretch. Hold for 90 seconds, increasing the stretches needed to maintain a strong sensation. Release. Repeat 2 to 3 times.
Insert the index fingers or thumbs of both your left and right hand into your vaginal opening just up to the first knuckle. Feel for the back wall of the vagina and then press out laterally (east and west). You should feel a strong stretch across the back wall. Hold for 90 seconds, increasing the stretch as needed to maintain a strong sensation. Release. Repeat 2 to 3 times.
Massage the Perineum
Apply a few drops the Prepare/Repair Elixir to the pad of your index or middle finger. Press the pad of your finger firmly against your perineum and use circular motions to massage. Be sure that you are pressing firmly enough to tone the deep tissues, not just moisturising the external skin. Massage for 60 to 90 seconds in each direction, clockwise and counterclockwise. Repeat twice.