If you are interested in avoiding an episiotomy (or a tear), you may find that massaging your perineum can help you to stretch for the birth of your baby. In late pregnancy there is an increase in hormones that loosen connective tissue in preparation for birth. This massage also helps you learn to relax the pelvic floor muscles while they are being stretched — and this takes practice!

You can begin any time during the last 6-8 weeks before your baby is due, as this coincides with the rise in hormone levels. Be sure to discuss this with your caregiver especially if you have genital herpes or vaginitis, as massage can worsen these conditions.

Begin by emptying your bladder and getting into a comfortable position, you can squat with your back against a wall, or sit on the toilet. A warm bath can help often the tissues and relax you or try hot compresses on your perineum.

First massage a good, natural oil into the area, such as wheatgerm oil, almond oil, vitamin E oil or any non-mineral oil (avoid almond oil if you have nut allergies). Massage and lubricate the skin and inner inch or so of the vaginal opening, and the lower vaginal walls. Pay special attention to any scar tissue from previous episiotomies or tears. Make sure your hands are clean, nails are trim and if your hands are rough, use disposable latex groves (the thin surgical type).

Doing the massage yourself:
The first few times, use a mirror so you can see where you are trying to massage and stretch. Notice the muscles of the perineal area — that tissue between the vagina and the anus. As you massage in the oil, feel how stretchy it is. To massage, place both thumbs into your vagina, up to the first joint. Gently pull and stretch downwards, towards your rectum, and up in a ‘sling’ or ‘U’ shaped movement. Do not massage the upper vagina near the urethra or clitoris — just the lower areas, as these are the ones that really need to stretch. Also try massaging with the thumbs on the inside and your index or middle finger on the outside.

Your partner doing the massage:
Make sure you are nice and relaxed — take a few deep breaths together, maybe do some thigh and back massage to get you ready. With well-oiled index fingers, begin by placing them into the vagina about to the first joint. Press down just until the woman is slightly uncomfortable, then stretch out and up in the ‘U’ shaped motion. You may feel a tingling or burning sensation — this is the same feeling that you may experience when your baby’s head begins to ‘crown’ which tells you to “relax, open up, let go, stop pushing”.

Continue to massage for approximately 5 minutes. If you faithfully massage each day, you will find that your tissues will noticeably soften and loosen. You will notice the perineum stretching wider, with less pain.

With your fingers inside, do a pelvic floor exercise. Feel where this muscle is and how strong it is. The more pelvic floor exercises you do, the stronger and more tone you will have. Feel how uncomfortable the stretching of your perineum is when you tense this muscle. Try to consciously release this muscle as you do the massage. Remember the connection between you mouth and jaw and perineum — if they are loose your perineum will be loose too. Always end a massage session with a few pelvic floor exercises to keep theses muscles well toned. Doing them after birth helps to rehabilitate these muscles.