First things first, let’s talk a bit about our anatomy. In women, the perineum includes the area at the back of your vagina and vulva and goes to your anus and rectum. Specifically, the perineum includes the back portion of the birth canal.
It is easy to go through life without thinking much about your perineum. However, without these rigid, firm perineal tissues that create a strong pelvic floor, we would not be able to walk upright, and we would pee every time we cough or sneeze. And, while these tissues need to be intact and strong, they also need to be flexible enough to stretch during childbirth to allow the baby to move through the birth canal. Unfortunately, the perineal tissues of many women lack flexibility and aren’t able to stretch during delivery. As a result, many women experience perineal trauma during childbirth. The perineal trauma can cause tears, or the need for an episiotomy (a surgical cut), both of which may require suturing to heal, and they often cause scarring and pain after childbirth, which can negatively impact future comfort and sexual function. Some tears can even result in incontinence of gas, urine or feces.
The good news is that just 5 minutes of perineal massage each day during the last several weeks of pregnancy has been shown in numerous clinical studies to decrease the incidence of trauma to perineal tissues, as well as the need for episiotomy, during childbirth; and the incidence of post partum pain during sex. In fact, perineal massage is commonly used in many European and other countries specifically to optimize healthy birthing outcomes.