January 17, 2020

Perineal Scar massage

When and how should you return to sex postpartum? If you have a partner, have an open and honest conversation about easing back into sex or other forms of intimacy.

When returning to touch of our vulva/vagina postpartum, “choose ways that feel comfortable and appropriate for your goals. Often, our lack of awareness, comfort, and confidence in knowing this part of our body may contribute to fear, pain, and tension we feel.” -me (Jen Torborg) from Your Best Body after Baby.

Ideas from Your Best Body after Baby in the chapter Returning to Sex:

  • Start with feeling yourself gently externally and then internally to notice anything that feels off or painful. Try to create positive touch experiences.

  • If you have a partner, have an open and honest conversation about easing back into sex or other forms of intimacy.

  • Modify intimacy to find ways that are not painful as your body heals physically and mentally.

  • Reach out to a pelvic floor PT for an individualized assessment and treatment plan to get you back to pain-free intercourse!

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My own experience with perineal massage postpartum

I did have a 1st degree tear that I chose not to have stitched up as it seemed pretty minor. I looked at it with a mirror with my midwives and made the decision together. I don’t necessarily recommend looking at your vulva immediately after birth but the pelvic PT in me wanted to know exactly what happened and make an informed decision with them about stitches or no stitches. I was very careful to imagine my “thighs glued together” for the next 7-10 days if I was up walking and minimized stairs as much as possible to improve healing.

In the first days/weeks postpartum I would lightly touch my vulva, perineum, and scar site to decrease any hypersensitivity during the healing process. I used very, very gentle touch during this part and only external, sometimes just over underwear or in the shower a gentle pat.

Around 4-5 weeks postpartum I started to touch the scar with slightly more pressure but still mostly external.

Around 5-6 weeks I decided I felt ready to start using internal touch. I begin perineal massage with first my finger while in the shower or lying down in bed. I did this every other day for about a week. Then I introduced a dilator and performed the massage again.

Then around 6-7 weeks I had an appointment with the midwives and consented to an internal exam to give me feedback on my healing. After that I began more scar tissue work on my perineal scar. As the sensitivity, pain, and numbness began to decrease at my scar and touch to my vulva, perineum and vagina felt better, I felt ready to resume sex with myself and then with my partner.

If you have any questions about performing perineal massage during pregnancy or postpartum, schedule an online session with me or one of the other awesome Vagina Whisperer therapists.

Jen Torborg, PT, DPT, CMTPT, is a pelvic floor physical therapist and author of three Amazon bestselling books: Your Best Pregnancy Ever, Your Best Body after Baby, and Your Pelvic Health. Jen treats clients in Ashland and Bayfield, Wisconsin through Orthopedic & Spine Therapy.

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