Dear Doulas,
Q: What is the best natural oil to use to do perineal massage? When do you begin in pregnancy and how often do you do it? How do you do it? Thanks.
Signed, Touchy Feely
A: Perineal massage is an evidence based exercise that you can begin doing in preparation for your birth at 36 weeks. The evidence states that perineal massage during pregnancy (for a first time laboring person), decreased the risk of episiotomy and decreased risk of trauma requiring stitches.
If you adequately prepare your pelvic floor for birth, you are creating connection, confidence and trust with this intimate part of your body.
Here’s a step by step guide to perineal massage
- Prop yourself up in a 60 degree angle, open your legs, and use a bit of lubricant on your thumbs.
- Place your thumbs on the inside of your vaginal opening, about an inch inside, and press straight down toward your tailbone.
- Hold them down for a minute or so, until you feel a stretch and maybe discomfort but not pain.
- Then begin moving your thumbs in a semicircle, pausing where there is tension, to encourage and allow the tissue to let go.
- Take time to investigate this part of your body. You can also incorporate pelvic floor engagement (“kegels”) and relaxation. Invite in a mantra – “every time I feel this sensation, I relax my bottom”, “soften and release”, or “let it go.”
A moderate level of discomfort is necessary for it to be effective. You can practice perineal massage daily if possible for about 10 minutes at a time. If you’re questioning whether you’re doing perineal massage correctly or effectively, set up an appointment with a pelvic floor physical therapist such as Ruth Elliot with Asheville Holistic Physical Therapy located in the Homegrown Families Health and Education Center (201 Charlotte St.).
The best oils for perineal massage are:
- Arnica Oil (unscented)
- Coconut Oil
- Almond Oil
- Olive Oil
Want more information? Check out Science and Sensibilities article on the evidence for perineal massage.
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