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Perineal massage to prevent episiotomy

Perineal massage to prevent episiotomy



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According to the FAME (Association of Spanish Midwives), massage of the perineum during pregnancy is effective in reducing perineal trauma and episiotomies.

The application of massage during the third trimester of pregnancy aims to stretch and soften the tissues, increase the elasticity of the perineum and familiarize the woman with the sensation of stretching, allowing this area to relax more during childbirth.

It is true that the application of perineal massage can cause discomfort during the first weeks, but these will gradually disappear. To avoid them the technique should be started without forcing the movements giving time for the tissues to get used to the massage.

There are women who find it difficult to apply massage, so the collaboration of the couple is necessary in the technique, thus favoring periods of intimacy between them.

We should not be overwhelmed by performing a perfect massage technique, being more important the perseverance in its follow-up. The woman herself and her partner will see the effects quickly, observing how her perineum is able to achieve greater tissue distension with less discomfort.

The massage can be applied with different lubricants, the most common are the rosehip oil, sweet almond oil and olive oil. We will try not to use body oils with perfumes, as they can irritate the vagina area.

1. Wash your hands well. Nails must be trimmed and clean.

2. Empty your bladder of urine before starting. Get familiar with your perineum. You can help yourself in a mirror.

3. Apply warm compresses or massage after you have showered.

4. Position yourself comfortably. You can choose to squat, semi-sit, or lean against the wall.

5. If you perform self-massage, it is easier to use your thumb. For the couple it will be the index and / or the heart. Lubricate your fingers with an oil before you start.

6. Insert your fingers into the vagina 3-4 cm, press down and to the sides of the vagina with a firm but gentle rocking motion, stretching the area until a slight stinging or burning sensation is felt. Then slide your finger from the vagina out and vice versa, maintaining light pressure for two minutes.

7. Place your fingers at the entrance to the vagina (fork) and press down for two minutes or until it bothers you. This will help you imagine the pressure on the baby's head.

8. Then take this area between the thumb and the opposing fingers, as a clamp, and perform a back and forth motion, from one side to the other, to stretch the tissue at the entrance to the vagina and the skin of the perineum. Do this movement for 2-3 minutes.

9. To finish, keeping the fingers in the same position, stretch from the inside out, covering the lower and lateral areas of the vagina and perineum skin, for 2 minutes. This will help you relax the area.

The frequency of the massage will be 3 times a week for 10 minutes. It will be done at least 3 weeks from the 34th week of gestation.

Sara Canamero de Leon
Matron

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