What is perineal massage during labor?
“Perineal massage during labor is a practice that is done with the intent of stretching out your perineum so that your baby’s head can pass through the birth canal without causing any tears”
The practice involves your OB or midwife inserting one or two fingers, usually their pointer and index finger, into the vagina during the pushing stage, to gently stretch the area side-to-side and down toward the anus in a sweeping, u-shaped motion. Lubricant is typically used, anything from water-based to baby shampoo. Confirming what is used at your place of birth is advised.
Sometimes referred to as “ironing the perineum”, the idea is that this gentle procedure helps make more space for baby. However, actual practice and application varies widely from provider to provider, with some stretching more rough and forcefully with less focus on slow stretching and gentleness.
To quote Evidence Based Birth again, “there is no reliable evidence that perineal massage with water-soluble lubricant during labor reduces the risk of severe tears. The only supporting evidence we have on this comes from studies that took place in settings with very high episiotomy rates.”
You may be wondering, how can I keep from tearing during birth?
Choosing a hospital with a low episiotomy rate is a huge first step. Use Leapfrog or CalCompare (in CA only) to research. Laboring and birthing in upright and sacrum-flexible birthing positions is also associated with lower rates of severe tears.
Want to learn more about your options and form a plan for talking to your OB or midwife? Work on a birth plan or schedule a 30-minute q&a session with Barb.
