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Perineal massage is a type of massage done on the woman's intimate area that helps to stretch the vaginal muscles and the birth canal, facilitating the baby's exit during normal birth. This massage can be done at home and, ideally, should be guided by a gynecologist or obstetrician.
Massaging the perineum is a good way to increase lubrication and stretch the tissues in this region, which helps with dilation, and consequently the baby's passage through the birth canal. That way it is possible to have emotional and physical benefits of this massage.
Step by step to do the massage
The massage on the perineum should be performed every day, from 30 weeks of gestation, and should last approximately 10 minutes. The steps are:
- Wash your hands and brush under your nails. Nails should be kept as short as possible;
- Apply a water-based lubricant to facilitate the massage, without the risk of infections, oil or moisturizing cream should not be used;
- The woman should sit comfortably, supporting her back with comfortable pillows;
- Lubricant should be applied to the thumb and index fingers, as well as the perineum and the vagina;
- The woman should insert about half of the thumb into the vagina, and push the perineal tissue backwards, towards the anus;
- Then, slowly massage the lower part of the vagina, in a U-shape;
- Then the woman should keep about half of the 2 thumbs at the entrance to the vagina and press the perineal tissue as much as she can, until she feels pain or burning and hold that position for 1 minute. Repeat 2-3 times.
- Then you should press in the same way towards the sides, also maintaining 1 minute of stretching.
Perineal massage is also useful to do postpartum, if you have had an episiotomy. It helps to maintain the elasticity of tissues, widen the entrance of the vagina again and to dissolve the points of fibrosis that can form along the scar, to enable sexual contact without pain. To make the massage less painful you can use an anesthetic ointment about 40 minutes before starting the massage, a good example is Emla ointment.
How to massage with PPE-No
EPI-No is a small device that works similarly to the device that measures pressure. It consists of just a silicone balloon that must be inserted into the vagina and must be manually inflated by the woman. Thus, the woman has total control of how much the balloon can fill inside the vaginal canal, enlarging the tissues.
To use EPI-No, lubricant must be placed at the entrance of the vagina and also in the EPI-No inflatable silicone balloon. Then, it is necessary to inflate just enough so that it is able to enter the vagina and after being accommodated, the balloon must be inflated again so that it can expand and move away from the sides of the vagina.
This equipment can be used 1 to 2 times a day, from 34 weeks of gestation, because it is completely safe, not negatively affecting the baby. The ideal is that it is used every day for a progressive stretching of the vaginal canal, which can greatly facilitate the birth of the baby. This small equipment can be purchased over the internet but can also be rented by some doulas.