The Bottom Line: The Basics of Perineal Massage

The practice of perineal massage is helpful in preventing tears during second stage. While exerting force to push the baby down the birth canal and over the perineum, the tissues must stretch to accomodate the baby's head, shoulders and body. By applying gentle pressure and stroking during the last two weeks of pregnancy, a woman can prepare her body for this intense time of birth. 

Benefits of perineal massage:

1. Helps the tissue to become supple and stretchy.
2. Gives the woman a chance to become accustomed to relaxing when slight pressure is on the perineum.
3. Enhances the birth by providing a tactile focal point for pushing.

This is a simple exercise, but might be easier accomplished with the help of a partner or spouse.

1. Wash hands and trim nails carefully.
2. Use a mild oil such as coconut oil, sweet almond or olive oil to lubricate the index finger.
3. Gently massage the perineal tissue, holding it between the index finger and thumb. 
4. Use mild pressure, which should feel like stretching.
5. Eventually use two fingers, expanding the tissue as you gently massage. 
6. Do not apply too much pressure. 

During birth, it is sometimes helpful for the midwife to apply mild pressure on the perineum to help a woman focus on where to push. By working the tissue ahead of time, it should be more stretchy and pliable.