The perineum is the area of tissue between the vagina and the anus. Performing perineal massage antenatally helps to prepare the perineum to stretch more easily during childbirth and reduce the need for stitches. It is thought over 85% of women will have some degree of tear during vaginal birth; therefore attempting to minimise this trauma is an important part of preparing for labour.
You can start perineal massage from 32-34 weeks of pregnancy. It can be done by you or your partner if you are both comfortable with this. It is a good idea to perform after a bath because the perineum is softer.
It is recommended to use an unscented, organic based oil, such as olive, sweet almond or sunflower, which lubricates the area and makes the massage more comfortable.
- Get comfortable
- Place one or both thumbs on and just within the back wall of the vagina, resting one or both forefingers on the buttocks.
- Press down towards the rectum and massage by moving the thumbs and forefingers together in an upwards U movement.
- Aim to massage for about 5 minutes at a time, each day or every alternative day for most benefit.
Do not do perineal massage if you have vaginal herpes or any vaginal infection. If you feel pain at any time, stop and try another time.
Optimal Fetal Positioning (OFP)
OFP is a theory developed by Midwife Jean Sutton. It suggests that through your position and posture you can help to encourage your baby to get into an ideal position to be born, before labour starts. Head down, with it’s back to your front or left side.
Babies who begin labour in the occiput posterior (OP) position are more likely to be born by caesarean section or instrumental delivery than those who are in the anterior position.
To encourage baby into anterior positions:
- Sitting – upright, forward leaning postures are good.
- Try and sit with your knees lower than your hips with your back straight.
- Use a cushion under your bottom and in the small of your back.
- Sit on a dining chair, leaning forwards, with your arms resting on the table.
- Kneeling on the floor leaning over a bean bag/birth ball/big pile of cushions (You can watch TV this way)
Try to avoid these things:
- Lying on your back
- Sitting on soft low sofas
- Long car journeys in ‘bucket’ type seats
- Crossing your knees
- Squatting, as it may cause the baby to ‘engage’ in your pelvis before it has turned into a good position