Perineum Massage / Ring of Fire

The theory is that a more flexible perineum will reduce your chances of tearing during delivery. In addition, massaging the perineum may also help you cope with the stinging sensation you’ll feel while your baby’s head is crowning. (This is also known as the “ring of fire.”) In fact, massaging the perineum may even help you avoid an episiotomy – and that sounds pretty good to me! When I tell pregnant women how important it is to massage the perineum, the majority of my clients have no idea of what I’m talking about. “Massage my what? ” they ask. “Are you kidding?” No one ever told me about the importance of regular perineum massages when I was pregnant, either. And again, this is valuable information that I could have used at the time! I can still hear my obstetrician saying, “Well, let’s speed up the process,” and little did I know that he meant it was time to get cut! I was never even asked whether I wanted an episiotomy, and it wasn’t like I’d been pushing for hours. I think it only took about four pushes before he decided that this was the way to go.

Well, that may have worked for him – and my daughter was born right after the cut – but to this day I believe that I did not actually need an episiotomy to deliver my six-pound bundle of joy! And I wasn’t expecting that my damn episiotomy scar would itch and become irritated each time I got my period. No one ever told me that having an episiotomy would mean having a scar, nor did anyone inform me that applying scar massage cream would have been very beneficial to me and my vagina … Jeez, nobody told me anything! A recent review of randomized, controlled studies of complementary and alternative medicine practices used during pregnancy showed that perineal massages may truly be helpful. (Frank Anderson, MD, MPH, and an assistant professor of Obstetrics and Gynecology at the University of Michigan Medical School, completed the review.

So, here are your instructions: Find a comfortable spot where you can sit down alone, or uninterrupted with your partner by your side. Find your perineum with a mirror, in order to see what it looks like. (You won’t always need the mirror.) You can apply warm compresses to the perineum for about 10 minutes, or a warm bath will do the trick if you’re feeling tense. Wash your hands, or have your partner wash their hands if they will be the one giving you the massage. Lubricate your thumbs and the perineum. You can use a number of different types of lubricants, including KYJelly®, vitamin E oil, and pure vegetable oil.

Some oils are designed specifically for this purpose, and they may or may not include herbal preparations. Regardless, place your thumbs about an inch inside the vagina, press downward, and pull toward the sides. You should feel a light stretching, tingling or burning sensation, but stop the process immediately if you feel immense pain. Hold this stretch for about two minutes, or until the area becomes slightly numb. (If you’ve had an episiotomy or tear in the past, make sure to pay special attention to that scar tissue because it will not stretch as easily, and it may need some extra work.)

Massage back and forth over the bottom area of the vaginal tissue, and rub the lubricant in at the same time. Pull the thumbs out slightly to simulate the motion of your baby’s head coming out of your vagina. If your partner is giving you the massage, they may use their thumbs or index fingers. (Sometimes it’s only possible to get one finger in until the area has been stretched. Be sensitive to your body and give feedback on the amount of pressure you’d like your partner to use.)

CAUTION: Avoid massaging the urinary opening (at the top of the vaginal opening) to prevent urinary tract infections. Do not massage the perineum if you have active herpes lesions, as this may cause the lesions to spread. I recommend that you start this process roughly 36 weeks into your pregnancy. But really, it’s never too late to start, unless you’re reading this on your way to the hospital or birthing center.

Now, getting your fingers in there may not be the simplest thing to do, so don’t be afraid to ask your partner for help. And if your partner has a hard time with it, too, then you may need to remind them of how you’re getting ready to push a child out of your vagina and into the world. This is the least they can do for you … I mean, really!

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