The Benefits of Antenatal Perineal Massage

If you’re pregnant, or your significant other is pregnant, you may have heard the term Antenatal Perineal Massage (APM) thrown around recently. Let’s put the medical jargon aside for a minute and break down what APM actually is and the benefits of performing this technique.

I want you to imagine you decided to enter the 4th of July annual hot dog eating competition (Look out Joey Chestnut!). Would you show up on July 4th and just go for it, having never trained? I sure hope not! For weeks leading up to the event, you probably tried various methods of stretching out your stomach, maybe even exercises for your jaw to open wider and chew more quickly. Alright, so the point I’m trying to make is that you should gradually push yourself, little by little, to prepare for the big event.

Birthing a child is A BIG EVENT! Tissues that have never had to stretch as wide as they will have to for baby’s delivery need to be trained prior to the event. This is where APM is of benefit. Using your finger, or a significant other’s assistance, you can manually prepare the tissues to respond better to pressure and stretching of the perineal tissues.

So if you want to:

• Reduce risk of tearing or need for an episiotomy

• Prevent hemorrhoids

• Prevent incontinence (urinary and fecal!)

• Decrease post-partum pelvic pain

• And improve perineal tissue healing

make APM a part of your daily routine.

When To Perform

Research recommends beginning APM once you’ve reached 34 weeks gestation. Additionally, my professional recommendation would be to perform APM once every other day starting at week 34, because it may make your perineal muscles sore (feel free to use ice packs or a relaxing bath as needed). Once you can tolerate every other day, then increase frequency to once every day for the remainder of your pregnancy.

How To Perform APM

Before you (or your partner) start:

- Wash hands and make sure nails are trimmed.

- Find a comfortable position. (For example: such as lying on your bed with upper body elevated)

- Use a water-based lubricant or coconut oil if necessary.

- Place your fingers at the vaginal opening.

- Practice a lifting contraction of the pelvic floor, then release it and slowly insert your fingers toward the back of the vagina (down towards the rectum) – slow and steady.

- As you continue to breathe, hold this stretch. Until you feel a slightly numb or tingling feeling (about 60-90 seconds)

- Continue to breathe, and slowly (while maintaining your pressure) glide your thumbs/fingers out to the side in a “U” motion.

- Repeat this motion for 5-10 minutes.

- Upon completion of the activity, utilize a warm or cold pack on the perineum to reduce any soreness.

Over the course of the weeks leading up to labor and delivery, you can gradually increase the stretching pressure as you feel comfortable.

Antenatal Perineal Massage

**DISCONTINUE the activity and call your pelvic health therapist or health care provider if you experience preterm labor contractions, vaginal bleeding, or other concerning symptoms.

APM is an excellent technique in preparing for a vaginal birth of your child. It's just one of many preparation activities you'll learn in our pregnancy sessions, as we want you to feel as confident as you can when it's time for baby's arrival.

If you have any questions, please contact Dr. Mariah Lohr at nomadicphysicaltherapy@gmail.com