Why I didn’t do perineal massage during pregnancy (even though I knew the benefits).

Here’s 10 other things that I did instead to minimise the chances of tearing during labour

I’ve got oil slathered all over my fingers, I’m sweating profusely, trying to balance at 34 weeks pregnant, with one foot on the toilet and the other on the floor, attempting to navigate my way round my huge belly to reach my vagina and somehow massage my perineum. It is NOT a pretty sight, I can tell you that for sure.

As a hypnobirthing teacher of almost 7 years, I knew some of the benefits of massaging ‘down there’ before going into labour, so I had to try it. Research says that massaging the perenium from 34 week onwards can help to minimise the risk of having a severe tear when giving birth. I’m not going to lie and I’m sure that you. can agree, the thought of your body tearing is enough to make anyone cringe.

So, there I am and eventually I manage to get to what I think is the correct spot and start massaging the area but it feels so weird and really unnatural at this point in pregnancy but I keep going, rummaging around and hoping that it’s doing something of benefit.

I need a lay down afterwards and the thought of doing it again tomorrow makes my roll my eyes. Then, I think to myself:

“Do I really need to be doing this?’

I think back to my first pregnancy in 2018 and I had never even heard of perineal massage then, so of course I hadn’t massaged down there, I only had a small tear during that labour so do I really need to be putting myself through this?

I already know from my own research that there are so many other factors that we have to consider when it comes to tearing during labour, massaging the perineum alone is not going to miraculously stop us from tearing if we disregard all of the other factors.

So let’s take a look at some other things that you could try during labour to minimise the chances of having a severe tear to the perineum, I tried all of them:

Ways to minimise the chances of tearing during labour, other than perineal massage:

So I sack off the massage, yep, you heard correctly, I did it once and never again, it just wasn’t for me. It felt uncomfortable, unnatural and a bit of a chore. That’s not me saying ‘don’t do it’ though, some people swear by it, do your own research and make that decision for yourself, you might find it a lot easier and more comfortable than I did and it might absolutely work for you.

So then I start to think about all of the other things that I can be doing instead to help minimise my chances of having a tear during labour. I think it’s a good thing to say at this point, that some people will always experience a tear to the perineum during labour, regardless of everything that they do to reduce this and that’s because their body may need that to happen to get their baby out. Often a tear happens during a contraction and women report that they did not know they had experienced a tear until after they have given birth and have the after birth checks.

Here’s all the things I personally did to help prevent a severe tear:

1/ Pilates during pregnancy

I religiously attended a weekly pilates class throughout both of my pregnancies, I really do think that the core strength and the stretching of the muscles / perineum helped so much to prepare my body for birth.

2/ Moving during labour

I went for a walk around the block during my second labour and used the birth ball during both labours. I swayed, I rocked, I paced, I walked, I bounced. I was instinctively using movement, helping to keep the perineum flexible.

3/ Staying hydrated

Drinking plenty of water / fluids during labour is great for the uterus but also for the whole of the body, including the perineum. I vividly remember downing a whole bottle of Lucozade sport during the birth of my son to give me energy more than anything but will also have helped the keep my muscles working too.

Read the full blog now on 4 things that your uterus needs to work efficiently during labour - Tap here to read.

4/ Using water on the perineum

This doesn’t necessarily mean a birth pool. I had a bath during my first labour and then got into the birth pool, during my second labour, I had a long shower and then the midwives used a warm compress on my perineum during the last stage to help keep it soft. We know that water makes the skin softer and more flexible.

5/ Listening to my body and only pushing as my body told me to

I really tuned into my body during my second labour, I listened to exactly what it told me to do. I got into a position that felt good and comfortable and then I pushed my baby out as it told me to. I was using my hypnobirthing breathing to allow me to push without straining or forcing. All of the hypnobirthing practise that I had done during pregnancy paid off as I felt confident to listen to my body and do what it needed me to do.

6/ Giving birth in an upright position

Not once did I lay down when giving birth to my son, I crouched on the bathroom floor for the majority of it whilst holding onto the loo as this felt like a comfortable position to be in. I then moved onto the landing where I was in an all four position whilst rocking back and forth on my birth ball. Being in upright positions will help the baby to put pressure on the perenium, therefore helping it to stretch more.

7/ Using hypnobirthing to relax my body

A panicked mind = a tense body and a tense perenium. The more tense down there is, the more likely you are to tear. It goes without saying that the more relaxed the mind is, the more relaxed the body is. I listened to my hypnobirthing tracks, I used my positive affirmations, I breathed, I used everything that I had learnt on my hypnobirthing class to allow me to relax my mind and body.

8/ Bouncing on my birth ball

As stated above, I bounced ALOT on my birth ball, the circular movements, the up and down bouncing, it will all help to keep the perineum soft, supple and flexible ready for birth.

9/ Planning a home birth - Read the full birth story of my son here

Research shows that giving birth at home = lower rates of perineal tearing*. There are many reasons for this but one of them is due to the fact that you tend to be less tense, more relaxed and there is less adrenaline in the body.

10/ Not rushing the ‘pushing stage’

During the final stages of labour, a baby will often take two steps forward and one step back. They come down and then back up again, if they are able to do this, it puts pressure on the perineum (as the baby comes down) and then gives it a break (as it goes back up slightly), this allows the perineum to gently stretch over time. If we rush the last stage of labour and really force down, often the baby doesn’t get chance to do this and the perineum isn’t ‘prepped’ as well for labour.

So, the big question, did I tear during labour without doing perineal massage?

I had small tears during both of my labours, it was questionable during my second birth as to whether I actually needed stitches or not it was that small, I chose to have a couple. I didn’t feel the tear happen at all during either of my labours and they both healed really quickly. Do I think it would have been any different had I done perineal massage? I guess we will never know the answer.

So, all in all, do the perineal if it feels right for you but don’t forget all of the other ways to minimise your chances of tearing too, these can make so much of a difference to your labour.

Take a look at this week’s trending blog that’s being read all over the world right now:

*Research studies:

• Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis 2010

• Perineal outcomes in a home birth setting 1998

• Incidence of and risk factors for perineal trauma: a prospective observational study 2013

• Tearing through evidence 2020