I often get asked by women does Perineal massage work? Is it worth doing? Am I wasting my time? How do I even do it?
So, I have entered the world of research to get you all your answers!
It may sound straight forward but perineal massage is where you are using your fingers to massage the perineum to prepare the tissues for labour. Women typically insert either index fingers or thumbs into the opening of the vulva and stretch towards the anus. The idea being you are stretching the muscles and skin getting you used to the sensation of crowning. But are you making a difference? Is it even doing what you think it is?
I was unable to find a written reference in my research. Though author Chen, Q et al 2022 stated that perineal massage stimulates the nerve endings in the skin, enhances blood circulation to the area and improves the elasticity of the perineal tissues. I was unable to find written resources to confirm this statement. However, the following articles support the use of perineal massage during the last month of pregnancy.
The World Health Organisation has written a list of recommendations for intrapartum for a positive childbirth experience. They recommend using perineal massage or a warm compress to the perineum in second stage labour to reduce the risk of perineal trauma.
The BMJ is a peer review journal who have written an article on whether perineal massage in the weeks leading up to delivery can help to avoid an episiotomy. They determined that if this was your first pregnancy that 1 in 16 women would have a decreased incidence of an episiotomy, if they completed perineal massage leading up to birth. That meant that for every 16 women who completed the massage one women would see the benefit. They found that if this was your second birth perineal massage did not help decrease the risk of an episiotomy. Rodrigues. S et al 2022 found that a warm compress + perineal massage at time of delivery increased the likelihood of an intact perineum after delivery.
A 2013 Cochrane review looked at how much and when should you start perineal massage. They concluded that similar to the BMJ journal that if this was your first pregnancy you may have benefit from completing perineal massage. The review recommended women can start perineal massage from 35 weeks pregnant. One to two times a week was reported to decrease the likely hood of needing an episiotomy during delivery.
So hopefully this answers all your questions. If this is your first pregnancy and you’re 35 weeks pregnant and find time once to twice a week to give your perineum a massage, its likely to decrease your risk of episiotomy during a vaginal delivery. The research indicated that if you did not complete perineal massage, you were at no statistically significant increased risk of episiotomy at time of delivery.
Bump Fitness does prenatal education session where we go through any questions you may have regarding labour and recovery after. We work with your health care team to ensure you get as much education as you can leading into labour. Get in touch today for your prenatal assessments.
- Beckmann MM, Stock OM. Antenatal perineal massage for reducing perineal trauma. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD005123. DOI: 10.1002/14651858.CD005123.pub3 https://www.cochrane.org/CD005123/PREG_antenatal-perineal-massage-for-reducing-perineal-trauma
- Chen Q, Qiu X, Fu A, Han Y. Effect of Prenatal Perineal Massage on Postpartum Perineal Injury and Postpartum Complications: A Meta-Analysis. Comput Math Methods Med. 2022 Jul 14;2022:3315638. doi: 10.1155/2022/3315638. PMID: 35872935; PMCID: PMC9303122.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303122/#B2
- Perineal massage in the weeks leading up to delivery helps some women avoid episiotomy. BMJ. 2006 Mar 18;332(7542):0. PMCID: PMC1403252. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1403252/
- Silvia Rodrigues, Paulo Silva, Fátima Rocha, Ligia Monterroso, João Neves Silva, Natacha Quintal de Sousa, Ramon Escuriet, Perineal massage and warm compresses – Randomised controlled trial for reduce perineal trauma during labor, Midwifery, Volume 124, 2023 https://doi.org/10.1016/j.midw.2023.103763. (https://www.sciencedirect.com/science/article/pii/S0266613823001663)https://www.sciencedirect.com/science/article/pii/S0266613823001663