TEACHING PARTNER OR SELF-MASSAGE OF THE PELVIC FLOOR

(See Fig 1.06 in textbook)

When a woman wants to try pelvic floor massage to prepare the perineal area for birthing, you can easily teach her or her partner.

Guidelines:

  1. Start daily perineal massage in the last four to six weeks of the pregnancy.
  2. If a herpes sore, vulvar hemorrhoid, or other vaginal problem is present, wait until the problem has resolved, and consult with your healthcare provider. Similarly consult with your healthcare provider if you are experiencing any signs of leaking amniotic fluid.
  3. Get a pure, unpreserved vegetable oil or water-soluble lubricant that you will feel comfortable with using for the massage.
  4. Wash your hands and clip your nails prior to the massage.
  5. Secure a private environment, where you can comfortably sit, leaning back on pillows or other supports, and relax your flexed, opened legs.

Procedures

Here are the steps to teach her or her partner to actually do the massage. She will need to determine if she would prefer to and can comfortably reach to do the massage herself, or if she would prefer her partner to help in this way. Regardless of whether you are teaching your client or her partner, utilize the webbing between your thumb and index finger to replicate the perineal tissues, and demonstrate each step below. Ask her to follow along using her own hand to practice.

  1. After making the preparations above, gently rub lubricant into the tissue between your vagina and anus, and into the first inch or two of your vagina. Avoid the urinary opening just above the vaginal opening
  2. With your thumb or fingers inside the vagina, press downward toward your anus and out toward your sides, maintaining gentle, firm pressure until you feel a slight stinging, tingling, or burning sensation. Sustain this pressure for about two minutes until numbness begins to occur in the area. (If performed by a partner, the index finger may be preferred.)
  3. Maintain the pressure for another three to four minutes while slowly stroking back and forth from the midline toward the sides of the vagina, simultaneously pulling down toward the anus.