Tag Archives: perineal trauma

Perineal Massage: better the devil you know?

Ah that lovely word massage. It conjures up images of candles and plinky music and warm, fluffy towels as puffs of hot, fragrant air waft through the room.

Then you lob the word “perineal” in front of it and it turns into an antonym.

Perineal massage, while a massage in its strictest definition what with its rubbing and kneading and all, kind of taints the idea of a massage.  For example, “comfortable” is not an adjective you could use to describe a perineal massage. Neither is “soothing”, “relaxing” or “rejuvenating”.

Perineal massage: better the devil you know? www.mindthebaby.ie MindTheBaby blog
Yeah, it’s not like this
photo credit: Schwangerschaft via photo pin cc

Let’s try “awkward”, “uncomfortable” and “stinging” instead.  I have never been happier that there is no full length mirror in my bathroom than from week 36 of my pregnancy when I could only just imagine what a vision of hefty loveliness I was with one foot perched on the toilet bowl, as I warmed almond oil between my hands and then creaked and groaned as I tried to reach over my bump, under my bump, around the back, to the side, to try and properly position myself to gain access to that sacred and sensitive perineal area.

Then there was the self discipline of going the course – was that long enough? was it strong enough? how much discomfort is enough discomfort?  Was that TOO much discomfort??!!!  To add insult to injury, the only way to know if it’s actually working is to have a baby.

It’s not pretty and it’s not sexy.  But, hey, here’s the important part: it really works.

You’d be some fool now to take my word for it, so don’t.  Take the Cochrane Reviews’.

In a nutshell, the summary says this:

“The review of four trials (2497 women) showed that perineal massage, undertaken by the woman or her partner (for as little as once or twice a week from 35 weeks), reduced the likelihood of perineal trauma (mainly episiotomies) and ongoing perineal pain. The impact was clear for women who had not given birth vaginally before, but was less clear for women who had. There were no randomised trials on the use of massage devices. Women should be informed about the benefits of antenatal perineal massage.”

There’s a couple of interesting things in there for me.  Firstly, it’s evidence based research that demonstrates that it does actually work.  Secondly, it throws out that chestnut that I’ve heard all the medical professionals say – “or your partner”.  Before I began the massage myself, I lost count of the number of conversations that went like this:

Me: “Hey, we should give that perineal massage thing a whirl one of these days”

Husband: “Yeah, great idea”

If I didn’t bring it up, it didn’t get volunteered.  I read between the lines.  A solo run it was!

Because perineal massage isn’t the most appropriate of dinner conversations, it seems to be one of those embarrassing pregnancy things that only gets whispered about outside of antenatal classes (like poo).  Hence why I was a little confused when a pharmacist handed me a small vial when I asked her for almond oil.  I was trying to figure out how many massages that would get me before I had to buy a new one and I was thinking not too many.  It was two weeks later before my yoga teacher put me straight that I needed a big whopper of a bottle of the good organic stuff from the health shop.

I also read that the best way to figure it out was to type “perineal massage” into Youtube and you’d get heaps of tutorials.  In case you’ve a very real fear of stumbling across a lot of porn by accident when you’re at work, I’ve done the hard work for you.  This video is it basically:

Nothing like a rubberised vagina to get you in the mood 😉

I started massaging from about 36 weeks, maybe 2-3 times a week and I really had to bully myself into it.  It’s fine really, it’s just a bit awkward and a little uncomfortable.  Apparently there’s also a contraption called an epi-no which does the job for you.  I haven’t had any experience of it myself – perhaps one of you have? When I reached my due date, I upped the ante a bit and did it everyday.  I think this was just a bit of first time jitters though.  When I had Baby S, I had a small graze which made me jump the first time I peed but then caused me no grief after that.  Was it the perineal massage?  I have no idea but tell you what, I’ll do it again the next time.  The summary from the Cochrane Review above says there wasn’t sufficient evidence to proof that it’s just as effective after your first baby but I, for one, will not be risking it!