Research and our clinical experience has shown that all women preparing for vaginal birth can benefit from perineal preparation.
As long as your bag of waters has not opened, there’s still time to begin perineal preparation. We recommend most begin at around 34 weeks of pregnancy.
You may receive more benefit and consider starting earlier if you experience any of the following:
Significant anxiety surrounding vaginal birth and perineal lacerations
Discomfort with intercourse or speculum exams, now or in the past (Rosenbaum 2012)
Pudendal neuralgia, vulvodynia or other pelvic pain diagnoses, now or in the past
3rd or 4th degree perineal laceration with previous vaginal birth
Urinary urgency/frequency, now or in the past
Benefits for those preparing for their first vaginal birth (including VBAC):
Reduced risk of perineal trauma requiring sutures
Reduced likelihood of episiotomy
Benefits for everyone:
Decreased postpartum perineal pain
Increases comfort with sitting (for infant care and feeding)
Improves the transition to sex and physical intimacy
Promotes return to pre-pregnancy exercise routine
NOTE: We do not perform internal pelvic floor examinations on women who are at risk of pre-term labor, have a cerclage or have been diagnosed with shortened cervix or other such risks in their pregnancy. If you are experiencing vaginal bleeding or your bag of waters has opened, we also do not perform internal examinations. Even without internal examination, however, we believe that a perineal wellness consultation can be beneficial in order to learn about birthing strategies and have an external evaluation of pelvic floor motor control. If you have specific questions about your pregnancy, please talk to your doctor or contact us for more information.
Rosenbaum TY, Padoa A. Managing pregnancy and delivery in women with sexual pain disorders. J Sex Med 2012;9:1726–1735.
Beckmann MM, Stock OM. Antenatal perineal massage for reducing perineal trauma. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD005123. DOI:10.1002/14651858.CD005123.pub3.
This article is a review of four high-quality studies including 2497 women.