Perineal massage is an important way to prepare your perineum (the area of skin and muscle between your vagina and anus) before birth. This can help you avoid perineal tears, bruising, and episiotomy within labor but can also provide pleasure and sensual connection to your own body. During your pregnancy, it is essential to learn how to relax and contract your pelvic floor muscles, as you prepare to bring another human into the world. We wanted to find out why and how introducing pleasure into the process of perineal massage is so important.
Why is perineal massage before birth important?
“Massage is not just a luxury in pregnancy; it’s a necessity. There is so much change happening both physically and emotionally at this time.” – Pregnancy massage expert Suzanne Yates
Most midwives will recommend antenatal perineal massage as a means to reduce perineal trauma, prevent tearing, and reduce perineal pain afterward, the effectiveness of which is discussed in this study. Most doctors will give out medical handouts to explain the benefits of perineal stretching and some of the risks when giving birth.
“40% to 85% of all women who give birth vaginally will tear.” Some of these tears are totally minute, but “about two-thirds of these women will need stitches.”
Perineal massage before birth can also reduce the need for an episiotomy, which is a surgical cut to the perineum during birth, especially for first-time births. Even if you have had a child previously, perineal massage can help increase the “stretchiness” of the skin and reduce some of the discomfort that you will feel.
“Women having their first baby, women 30 years or older, and women who have had episiotomies before have fewer tears and less severe tears when perineal massage is done during the last weeks of pregnancy.” – American College of Nurse-Midwives
What isn’t divulged by the midwife or doctor is how this process doesn’t have to be purely a medical one – it can be a potentially sensual experience too. We spoke to Sexological Bodyworker, Jessica Parker, to find out more about the ability to connect with your sensual self during perineum massage before birth.
She told us that it’s so important to connect with that area. It’s a spot that you don’t normally focus on but will undergo a lot of strain during pregnancy and birth. You need to learn how to relax, contract, and manipulate your body with the baby. “You’ll have the actual biofeedback of that area”, rather than pushing against the unknown and leaving it as a painful mystery the doctors will solve.
This physical connection to yourself will also help you to reconnect with yourself postpartum. Sex after giving birth can be a whole new experience, especially coming accustomed to your new body. This area doesn’t have to be reduced to a baby machine, because you already know of the pleasurable potentials. The perineum can also be an erogenous zone if you stimulate it as one.
How to do a perineal massage
It is advised by midwives that you begin your perineal massage 6 weeks before the due date. Make sure you’re relaxed with washed hands, trimmed fingernails, and your knees bent. By using lubrication for the perineal tissue and your hands, the process will be more comfortable.
“Vitamin E oil or almond oil, or any vegetable oil used for cooking—like olive oil. You may also try a water-soluble jelly, such as K-Y jelly, or your body’s natural vaginal lubricant. Do not use baby oil, mineral oil, or petroleum jelly.” – American College of Nurse-Midwives
The idea is to gently stretch the fourchette (the skin connecting the vagina to the perineum). You do this by inserting the thumbs or fingers into the vagina about an inch and a half and pressing down toward the anus. You can hold this for up to 2 minutes before massaging the inside of the vagina and the perineum whilst relaxing your pelvic floor muscles for around 10 minutes.
The perineal massage should be done once daily, and you will begin to notice more stretchiness and less discomfort after a couple of weeks.
Aside from preparing the actual tissue for birth, focusing on this area with pelvic floor exercises and perineal massage makes it healthy. It can also help to heal from previous episiotomies, hemorrhoids, or scar tissue. Like with any massage, perineal massage helps relieve muscle tension.
In a typical health system, the best you get regarding the perineum is the standard medical hand out sheet. However, it is important to note that everyone is different and you, like many others, may have never explored your perineum previously at all.
Though some women may find this area sensitive to light touch, others can find it totally numbed. Sometimes it’s not the most comfortable thing as there can be a lot of tension there. These are all okay and are a process of self-discovery, of getting used to the touch or awakening the nerve endings.
Jessica explains that you want to associate as much pleasure as possible within this process, as this helps the body to relax into it, preparing you for the birth but also connecting you to your body. Some people go as far as having “orgasmic births” to not only counter the pain of contraction with the rush of the oxytocin love hormone, but also to relax the muscles around.
Jessica facilitates pregnancy massages, and in her sessions…
“I like to give a practical demonstration of where I do it. They can either film it or use a mirror. Then, if they can reach, they learn how to do it themselves. If they can’t do it with their own hands, then I recommend incorporating a female vibrator, and if they have a partner there I can facilitate how they can do it on them. I go through different pressures and techniques and create a pleasurable experience for them.”
Using lubrication can make for a lubriciously erotic time just as it adds to your sex life. So why not give it a go and make your sexual health care routine a pleasurable one. It also means you’ll be getting your daily dose of happy endorphins – especially if an orgasm is involved.
To add: don’t pressure yourself into making this a pleasurable experience if you aren’t feeling especially aroused. Remember, it is your journey, so treat it right – with love and care.