Perineal massage
Massaging the perineum (i.e. the area between the vagina and anus) during the last few weeks of pregnancy, from 34 weeks on, helps to stretch the outlet and prepare the lower birth canal for delivery. It may also reduce the incidence of a tear or the need for an episiotomy - although this is by no means firmly established. Perineal massage should not be performed if you have a skin lesion without seeking the advice of your doctor or midwife.
Perineal massage should be comfortable but give a feeling of stretching similar to that which will be experienced when the baby's head presses against the pelvic floor. A non-irritant lubricant is necessary such as a cold-pressed natural vegetable oil. To perform this exercise, put your thumbs 2-4 cm into the vagina and press down towards the rectum; maintain this steady pressure as you move your thumbs upwards along the sides of the vagina in a rhythmic 'U' or 'sling' type movement, as indicated in the figure. (Note that you should avoid the urinary opening).
Try to let the perineum relax as you are performing the massage. Continue the massage for up to five minutes at a time and repeat it on alternative days. Follow the massage with five strong contractions of your pelvic floor muscles. These are the muscles that you use to hold-on when you want to go to the toilet - but have to wait. By massaging and exercising this area you will become more aware of the pressure sensation that you will feel during delivery. By relaxing as much as possible during the period of stretching, you are preparing yourself to 'let go' when baby's head emerges. And by contracting the pelvic floor muscles, you maintain muscle strength and become familiar with the different sensations of tightness and relaxation in this.
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