What is perineal massage? How does it help for labour?

Let’s establish where the perineum is and then let’s talk about why anyone would ever what to do massage there!
 
Your perineum is the area of skin and muscle between the vagina and the anus. When you give birth for the first time vaginally, this area will stretch to a point that it never has before. There is a school of thought that, by massaging and stretching this area in late pregnancy, it can help you prepare for giving birth to your baby and will minimise the likelihood of tearing…
 
…is it sounding a bit more appealing now?
 
Massaging your perineum towards the end of your pregnancy can also reduce your chances of needing an episiotomy. It may also reduce tearing. Even if you have had a baby before, perineal massage can help to reduce discomfort after the birth.
 
Perineal massage aims to relax, stretch and soften the perineal area. It will help the opening of your vagina to stretch more easily as your baby is born.
 
When should I start doing perineal massage?
Women would usually start do this in the final six weeks of pregnancy. Not only will it minimise the chance of tears to the perineum during childbirth. When done correctly in pregnancy, it helps prepare for the sensations experienced during childbirth.
 
How do you do perineal massage?
Perineal massage should focus on the inside of your vagina, though you may still feel the skin on the outside stretching.
 
Here’s how to do a perineal massage:

1. Choose a comfortable position. This could be sitting or lying down, or you could try standing with one foot on a chair/bath. You could even try doing the massage in the bath or shower, where the warm water will help to soften your perineum.
2. Make sure your hands are clean and your nails are trimmed.
3. Use a natural lubricant such as olive oil/sweet almond oil to your hands and the perineal area.
4. Place your thumbs (or two fingers*) 3cm into the vagina (half your thumb).
5. Massage the area by gently rubbing the perineal tissues between your thumb and fingers.
6. Press downwards and to the sides, gently stretching until you feel a tingling sensation. The feeling lessens after a few moments.
7. Once this sensation is felt, hold the stretch for around one minute, until the feeling subsides. Gently massaging the lower part of the vagina by moving your thumb backward and forwards. While massaging also hook your thumb onto the sides of the vagina and gently pull these tissues forward. Why? Because as your baby’s head descends, it will do this stretch as they are being born.
8. Continue to gently rub and stretch the perineum for around 3-4 minutes each time you do this.

 
Discontinue if you feel pain.
 
Start perineal massage from 34 weeks pregnant and aim to do it at least once / twice a week.
 
The bigger your baby gets, the more cumbersome it can be to do perineal massage to yourself.
 
*If your partner is willing, they can do it for you. The process is the same, although ask them to swap the positioning around – so it is their index fingers inside the vagina and their thumbs on the outside.
 
Find a routine that works for you and stick to it. Perineal massage shouldn't hurt, though it may feel a bit uncomfortable, particularly at first. After you've been doing it for a few weeks, you may notice the skin and muscles around your vaginal opening becoming looser. This is a great sign that perineal massage is working.