Pregnancy / 7 December, 2017 / Becca Maberly

The #TBT Repost: Will Perineal Massage Reduce The Risk Of Cuts And Tears?

This weeks #TBT post is from 2013, provided by Doctor and Daughter.

Perineal massage is something that has become more “fashionable” over the years – with more and more women being advised to massage their perineum (the area around your vagina) with certain oils (such as almond oil or olive oil) from about 35 weeks.  What many women want to know, before they embark upon this “challenge” (which indeed it can be at 35 weeks pregnant!), is, “will it reduce my risk of tearing?”.

There have been a few studies recently which would seem to suggest that it can be useful in helping to prevent perineal trauma during a vaginal birth. The most comprehensive study to date suggests that women who practise perineal massage from approximately 35 weeks’ gestation are less likely to have perineal trauma which requires stitching. This particular study concluded that for every 15 women who practise perineal massage before a vaginal birth, one fewer will receive stitches following the birth.

However, these results have also shown that women who practise perineal massage are 16% less likely to end up with an episiotomy. This means that the reduction in perineal trauma requiring stitches following a vaginal birth is almost entirely due to the fact that she is less likely to have an episiotomy, rather than there being less trauma to the perineum.  This is thought to be due to the fact that women who were instructed in perineal massage became very motivated to achieve a vaginal birth with an intact perineum and consequently, may have been more likely to want to keep pushing longer and oppose an episiotomy unless it was clearly necessary.

These reductions only seem to be significant for women who have never previously had a vaginal birth.  But, for women who have had a previous vaginal birth, perineal massage before the birth appears to result in less reporting of perineal pain three months after the birth, even for those women who do not have an episiotomy.

It is interesting and surprising perhaps, to note that women who massaged the most frequently did not seem to be able to further reduce their chance of an episiotomy or perineal trauma but may lessen their likelihood of perineal pain at three months after the birth.

There were no significant differences observed in the incidence of instrumental deliveries (forceps or ventouse), sexual satisfaction, or incontinence for any women who practised perineal massage compared with those who do not massage in the study that reported these outcomes.

So, the answer is not really that clear. It would seem that an awareness of the issue can perhaps motivate you to oppose an episiotomy and to try to achieve a vaginal birth with minimal trauma.  More studies will need to be done to prove the efficacy of perineal massage in reducing tears, but in the meantime it would seem to be a perfectly safe practice and may well help you to give birth intact.

If you would like to know more about perineal massage, you can ask your midwife or doctor who will best advise you on how to do it safely.

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