Prepping for Labor: The Benefits of Perineal Massage


Why should I stretch my perineum before labor and delivery?

Perineal massage/stretching can help prepare the area for labor because it increases blood flow and elasticity to the area. It can make for a more comfortable birth by preparing your body for this sensation during labor and also helps reduce your chances of having an episiotomy and/or significant tearing.

If you don't feel comfortable or would rather not perform perineal massage on yourself, it is worth seeing a women’s health physical therapist that does internal work to help you stretch this area out. This helps you return to your normal postpartum life such as sex that is not painful, tampon insertion, urinary stress incontience.

Stretching Positions

You can start perineal stretching at 34 weeks.

Pelvic Floor Pull Apart: Laying on your side, use your top arm to grab your butt cheek inside your butt crack and up it up towards the ceiling.

Hip Squeeze: have a partner squeeze the top of your hips at the top of your pelvis, your partner should keep there arms parallel to the ground an perpendicular to your pelvis.

Pelvic Opener: Using a railing sit your weight back into your heels as if you are squatting focusing on your inhalation. Otherwise focus on sitting on a yoga block.

Instructions

You can perform independently or have a partner help (wink, wink).

  • Assume a semi-reclined, side-lying, half-kneeling or standing with one foot up on a stool. Another great place for this is your bathtub with warm water. 

  • Use a water soluble lubrication (we recommend Slippery Stuff lubrication), or you can use vitamin E, olive oil, coconut oil, rose oil, slippery stuff or any organic oil that contains no alcohol.

  • Place your finger inside your vagina and stretch the back side of the vaginal wall from 3:00 to 9:00. You can stretch and hold. It should feel a bit uncomfortable like the sensation of opening your mouth wide and pulling your cheeks apart. You can also pinch and push the tissue between your vaginal opening and rectum to stretch and move tissue in this area. This is the most common area for tearing during labor and delivery. Perform for 5-10 minutes, 4 times per week starting at 34 weeks. If you are a high risk pregnancy consent your doctor.

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Tip: Think of your vaginal opening as a clock, with the clitoris as 12:00 and your anus as 6:00. 3:00 and 9:00 are the left and right sides. Avoid 12:00 (your bladder). Insert pointer finger in your vaginal opening. Stroke applying pressure outward (like you are stretching the opening wider) from 3:00 to 6:00 and repeat from 9:00 to 6:00. 

  • Gently roll back and forth over the scar for 1-3 minutes.

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