Perineal massage: what it is and how to do it correctly

Perineal massage is a type of massage performed on a woman’s intimate region that helps to stretch and strengthen the perineal muscles, facilitating the baby’s exit during normal birth and reducing the chances of lacerations (“tears”).

This massage can be done at home but, ideally, it should be guided by a gynecologist, obstetrician or pelvic physiotherapist.

Massaging the perineum is a good way to increase lubrication, make the skin more supple, make the muscles stronger and more elastic, as well as providing greater comfort and increased sexual pleasure.

How to do perineal massage

Perineum massage should be performed every day, starting at 30 weeks of pregnancy, and should last approximately 10 minutes. The steps are:

1. Wash your hands and run a brush under your nails. Nails should be kept as short as possible;
2. Apply a water-based lubricant to facilitate the massage, without the risk of infections, do not use oil or moisturizing cream;
3. The woman should sit comfortably, supporting her back with comfortable pillows;
4. The lubricant should be applied to the thumb and index fingers, and also to the perineum region and entrance to the vagina;
5. The woman should insert about half of the index finger into the vagina, and push the perineal tissue backwards, towards the anus;
6. Then, push the fabric to the sides and, after 2 minutes, return to the starting position;
7. Next, you should slowly massage the lower part of the vagina, in a U-shape;
8. Place half of your 2 thumbs or your index finger (whichever is easier) at the entrance to the vagina and press the perineal tissue as much as possible, until you feel discomfort or a slight burning sensation and maintain this position for 1 minute. Repeat 2-3 times.
9. Then you must press in the same way towards the sides, also maintaining 1 minute of stretching.

Perineal massage is also useful postpartum if you have had an episiotomy, as it helps maintain tissue elasticity and dissolve fibrosis points that may form along the scar. Furthermore, it reduces sexual discomfort, which is very common postpartum.

How to massage with EPI-No

The EPI-No is a small piece of equipment that works in a similar way to the device that measures pressure. It consists of just a silicone balloon that must be inserted into the vagina and which must be manually inflated by the woman. Thus, the woman has total control over how much the balloon can inflate inside the vaginal canal, stretching the muscle, mucosa and skin tissues.

To use EPI-No, lubricant must be placed at the entrance to the vagina and also on the EPI-No inflatable silicone balloon. Then, it is necessary to inflate just enough so that it is able to enter the vagina and once accommodated, the balloon must be inflated again so that it can expand and stretch the perineal muscles and the internal vaginal mucosa.

This equipment can be used 1 to 2 times a day, from 34 weeks of pregnancy, as it is completely safe and does not negatively affect the baby. Ideally, it should be used every day to progressively stretch the perineal muscles, which can greatly facilitate the birth of the baby. This small equipment can be purchased online but can also be rented by some doulas.