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Perineal massage is a type of massage which is used to help pregnant women prepare for delivery. This massage is performed to lubricate and stretch the perineal tissue between the vagina and anus. While perineal massage is certainly not required during pregnancy, it can reduce the risk of perineal tearing during delivery, and it can make women more comfortable during the delivery process. This technique can be performed by a pregnant woman, her partner, or a birthing assistant such as a midwife or doula.
Ideally, perineal massage should be performed daily during the last six weeks of pregnancy. The technique is designed to make the perineal tissue more flexible so that it will stretch comfortably during the delivery of the baby. In addition, it gets women accustomed to the tearing and pulling sensations in the area which will occur during delivery, which can make them feel more relaxed as they give birth. The increased relaxation will make women less prone to tensing at a critical moment, which also reduces the risk of tears.
To perform perineal massage, the person doing the massage should trim his or her nails and wash the hands thoroughly. Gloves can be worn for additional protection, although they can make the massage a bit more difficult to do. The woman should recline in a comfortable position with her legs spread, allowing the person performing the massage to easily see the perineum. If the woman is doing her own massage, it can help to work with a hand mirror during the first few sessions.
The hands should be lubricated with massage oil or a water-based lubricant. Scented products should be avoided, as they can irritate the mucus membranes around the vagina. It is also important to stay away from the urethral opening, to avoid creating an infection. Transferring the fingers between the anus and the vagina should also be avoided for the same reason.
Lubricated thumbs or forefingers should be inserted into the vagina, and then gently pulled down and out to stretch the perineal tissue. Once a point of slight tingling has been reached, the position should be held for a few minutes before the tissue is released and massaged again. The goal is not to create pain, but to gently stretch and lubricate the tissues. If tearing or burning sensations are experienced, the pressure is too strong. Using another finger, the perineal tissue between the vagina and the anus can be gently massaged by working the tissue between the fingers.
Each massage session can take 10-15 minutes. Women should stop if they feel discomfort or pain, and they should be aware that intense pressure can create soreness and inflammation around the perineum. Pregnant mothers should also know that perineal massage will not guarantee freedom from perineal tearing, although it will greatly reduce the risk of tears.
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