PERINEAL MASSAGE FOR PRENATAL AND POSTPARTUM SUPPORT

  By Megan Vickers, Women’s Health Physiotherapist

Prenatally, perineal massage prepares the soft tissue around your birth canal for the birth of your baby; it can shorten the second stage of labour and help prevent tears. We recommend beginning perineal massage at 34 weeks, performing it 2 to 3 times per week up until labour.

Postpartum, perineal massage supports the healing of tears and episiotomy scars. To repair wounds, your body generates scar tissue which is comprised of irregular lines of collagen and fibrin that don’t stretch easily. With activities such as intercourse, this new tissue can feel like it is tearing when in fact it is just stretching. Postpartum perineal massage encourages elasticity in the scar tissue, easing pain and discomfort. We suggest perineal massage begin at 6 weeks postpartum, and be done 2 to 3 times per week until the tissues have healed and softened.

PERINEAL MASSAGE METHOD

You can massage yourself or invite your partner to massage you. Begin by situating yourself in a comfortable position that naturally opens and stretches your perineum (your perineum is situated between your vaginal opening and your anus). For example, one foot on the side of the bathtub, or on the floor or bed with your legs splayed.

For a more sumptuous massage, warm the oil before you begin by running the closed bottle under hot water.

STEP 1

Moisturise & Prepare the Tissues

Apply a few drops of the Prepare/Repair Elixir to your fingers and gently massage the oil into your perineum, vaginal vestibule and labia, coating and moisturising the tissues. This lubricating massage prepares your tissues for the stretching activities to follow. Rub gently, lovingly and with care, attuning to your body. Do only what feels good to you. Pay special attention to the opening of the vagina (the vestibule) where it meets the perineum.

STEP 2

Posterior Stretch

Insert one finger or thumb into your vaginal opening—just up to the first knuckle. Press directly backwards (towards your rectum) until you feel a strong stretch. Hold for 90 seconds, increasing the stretches needed to maintain a strong sensation. Release. Repeat 2 to 3 times.

STEP 3

Lateral Stretch

Insert the index fingers or thumbs of both your left and right hand into your vaginal opening just up to the first knuckle. Feel for the back wall of the vagina and then press out laterally (east and west). You should feel a strong stretch across the back wall. Hold for 90 seconds, increasing the stretch as needed to maintain a strong sensation. Release. Repeat 2 to 3 times.

STEP 4

Massage the Perineum

Apply a few drops the Prepare/Repair Elixir to the pad of your index or middle finger. Press the pad of your finger firmly against your perineum and use circular motions to massage. Be sure that you are pressing firmly enough to tone the deep tissues, not just moisturising the external skin. Massage for 60 to 90 seconds in each direction, clockwise and counterclockwise. Repeat twice.

8 NOURISHING THINGS YOU CAN DO FOR YOURSELF TODAY

Healing can be overwhelming at times. I realise we all have different stories & different experiences, but from what I noticed, we end up in a pretty similar place…

…Forgetting about taking care of ourselves. Neglecting our needs. Often accompanied by a range of autoimmune conditions. Exhausted. Sabotaging our happiness. Addicted to sugar, drugs, alcohol, shopping, working… And we are aware that we must take care of ourselves, but it’s all too much. Too overwhelming. Too stressful. Too complicated. Too expensive. Especially when we have little ones.

So starting small is key. Setting achievable goals. Doing things slowly and with a lot of self-compassion. I have listed 6 things that I try to do, even on the worst of days. They help me feel human on the days I am too depressed, anxious and flared up. On the days when everything hurts. On the days when all I want is to be taken care of. Sometimes, these small things can turn the day around.

⋒ Drink warm water. Drink lots of warm water (lukewarm in summer, hot in winter) with small sips throughout the day. In Ayurvedic terms drinking warm water supports your agni aka the digestive fire, which helps with digestion, elimination, and moisture levels of your body. When we are well hydrated we feel better, have more energy & clarity. Invest in a thermal stainless steel bottle and take it with you everywhere.

⋒ Take 5 minutes to breathe deeply. Just 5 minutes. Breathe in for a count of 5, and breathe out for a count of 10. That’s 4 breaths a minute, 20 breaths in total. Try in through the mouth and out through the mouth x 5, in through the mouth and out through the nose x 5, in through the nose and out through the mouth times x5 and in through the nose and out through the nose x 5. Feel how the breath touches your nose and throat and fills in your lungs with fresh air. Enjoy this moment. You can repeat it a few times a day if you want.

⋒ Dance to your favourite songs. Move gently and listen to your body. It will tell you what it needs. If you need some inspiration, check out my Intuitive Movement playlist here.

⋒ Take a shower or a bath. Bonus points for some essential oils and herbs. Choose them mindfully. Smell them and pick the ones to make you feel nurtured and loved. Remember to always dilute them in a little of a carrier oil, like sunflower or olive oil. If you don’t have any oils, get a few basic ones, like Lavender (Lavandula anguvstifolia), Roman Chamomile (Chamaemelum nobile), Rosemary (Rosmarinus officinalis), Juniper Berry (Juniperus communis) and Geranium (Pelargonium graveolens). I recommend getting these at Neal’s Yard Remedies, Oshadhi or Materia Aromatica.

⋒ Go to bead earlier that usual. Preferably before 10pm. It’s amazing what a good nights sleep can do. Trust me.

⋒ Walk barefoot on the grass. Barefoot walking on earth, also known as grounding is believed to discharge our energy field, much like an earthing device does in case of a lightning hitting a building. Grounding is believed to relieve tension, calm down our nervous system and help you sleep better. I love it.

⋒ Expose your face to daylight. It helps regulate your circardian rhytm and is simply life giving.

⋒ Talk with someone you trust and feel safe around.

Do you have any practices or rituals that you hold on to when the going gets tough?

Warmly, Olivia

A NOURISHING EVENING RITUAL

I’m not gonna lie and say my evenings always look like that - life has far too many variables - but when I can and the stars align, this is what my perfect evening looks like.

After the kids are in bed, at 8pm sleeping (which is a miracle in itself) like angels and dreaming the sweetest of dreams, I begin tending to myself. Sometimes I manage to do it all, sometimes some, sometimes none and that’s totally fine. No self-criticism allowed.

⋒ Electronics off. No emails. No messages. No phone calls. No research. No shopping. And if I really, really, really have to, I will wear blue light blocking glasses not to mess up my hormones.

⋒ Dry brush my skin. It’s the perfect beginning of the evening bath time for me. It’s meant to be really good for aiding detoxification and skin health. I just find it bring me back into my body and makes me feel alive. I love how my skin tingles afterwards. They say this is better to do in the mornings, but I prefer the evenings. Do what works for you.

⋒ Take a bath or a shower, depending on my mood. Meditate while in. Take time to gently scrub my skin and massage it with aromatic oils. Wash my hair and apply all the lotions and potions. A face mask. Come out renewed, relaxed and refreshed. Take time to apply aromatic oils and balms to my face, body and hair. Treat my self with utter reverence. Take time to Gua Sha my face & shoulders and massage my scalp. Massage my feet, my breast and my belly. I have a selection of oils, balms, creams and lotions and I tend to choose these intuitively depending on my needs.

⋒ Yin yoga, neck, shoulder & pelvic stretches and myofascial release while breathing really deeply and intentionally. I’m currently breastfeeding and out of the last 8 years, 6 were spent breastfeeding my girls. It’s taken a toll on my spine, shoulders and posture so chest openers are a must. Pelvic stretches are just so pleasant and simply wonderful. Yin yoga helps you release the day. Myofascial release helps with chronic body pain, stress release and mobility.

⋒ Cup of relaxing herbal tea in bed, while planning tomorrow and writing down my “want to do list”. That way I can let go and sleep well without worrying about the day ahead.

⋒ Read a book. Nothing serious. Nothing study related.

⋒ Sex, self pleasure, sensual massage. Anything pleasurable. If I’m in the mood. Never force yourself and do only what feels good, alone or with a person you trust.

⋒ Womb & belly massage, pelvic steam or dearmouring. I hold a lot of trauma in my pelvis & abdomen, so tending to it is an important part of my day. These one one the most nourishing practices & powerful practices for transforming menstrual, obstetric & sexual trauma. Remember to breathe through it and let any sounds your body want to make come out.

⋒ Misting some lavender or chamomile on my pillow to help me sink into the deep reveries.

⋒ If I struggle to fall asleep, and often I do, I play a meditation or self-hypnosis.

When I manage to implement these into my routine, and have a calm, nourishing, mindful evening I sleep better and feel stronger and healthier the next day. If you have any practices that make you feel nourished, calm and cared for please share - I’d love to know what works for you!


Warmly, Olivia

POSTPARTUM INFECTION DIARIES

I was already burned out and traumatised by the pregnancy - I wasn’t planning on getting pregnant, because I was in such a depleted place and I knew it would be too much. Yet, my daughter had other plans. 

After an extremely difficult and disembodied pregnancy, I gave birth to my beautiful girl. The birth itself was a beautiful, empowering experience. My midwives protected my space and honoured my boundaries. For the first time in a long time, I felt powerful. Like I could move mountains, which was a very different experience to the first labour, which left me traumatised. 

Everything was going fine, even though I was a little anxious. Then, about five postpartum I begun experiencing pain in lower abdomen - I could’t get up easily or walk. There was this intense pressure on my labia and perineum. I took it as a symptom of postpartum recovery. However, in a day or so, a strange smell of my lochia followed. I knew something was going on. I could feel it. But I was frightened to make it real. 

Then, exactly 10 days after the birth, as I was showering, I felt something at the entrance of my vagina. So naturally, I tried to feel it, which lead me to pulling out a 10cm piece of a rotting membrane. 

I could feel all my blood rushing into my head and my heart pounding. My legs became soft. The next thing I recall, I am waking my husband to tell him that something come out of me. 

I was so terrified I completely lost the sense of my body. I didn’t want to go to the hospital, which I presume was flight - it would have made this threat real. 

I was scared. 

I disassociated. 

I don’t remember getting to the hospital and while in the hospital I only have few short snippets of memory. I was so deeply in the freeze response, but also in fight - there was a threat to my life and we had to deal with it. 

I kept hearing words like infection, sepsis. It all just echoed in my head. The only thought was: I am never going to see my children again. I am not going to see them grow up. I didn’t even managed to get to know Sienna, and I am already dying. I was sure it was a punishment for not wanting to be pregnant. I dissociated further. 

The only thing that mattered was my kids. 

I was given intravenous antibiotics and thank goodness they worked. 

But my mind or body didn’t calm. 

I was afraid to sleep.

I was afraid of the dark.

I was afraid of being alone. 

I was afraid of being without my children. 

I was constantly worried that the infection will come back and I will die. That it is not over yet. 

I froze more and more, and got to the point that when I was looking at my daughters little face, I couldn’t see it. I couldn’t remember how she looked. I couldn’t remember what I said or did. 

I wasn’t.

I felt demented. 

I wasn’t in my body. I wasn’t in my head. 

I left life. 

Everything was on autopilot. 

I have hardly any memories from the first year of my daughters life. 

So much shame and pain. 

We are meant to want and love our children, the society says. “You don’t deserve to live, because you weren’t ready to welcome your child” I kept hearing over and over in my mind. 

Everything was so painful, I couldn’t let myself feel. 

I froze more and more. Disassociated more and more, until I wasn’t. 

For the next 4 month or so after the infection, I was sure it’s going to be back and kill me. 

It didn’t help that we went into lockdown when my daughter was only 1.5 month old. 

It was constant threats. I was bombarded by threats to my life, my childrens lives, my husbands life, the loss of family, the loss of status quo (which for someone with my background is a lot). 

I was moving from freeze, to fight, to flight in a space of minutes. 

Everything was a threat. 

And I was burying it deeper and deeper. 

Laying bricks of frozen tension upon bricks of frozen tension. 

I couldn’t cry for over a year. 

I was getting so intensely angry, which was the only emotion I was able to feel. No joy, no sadness.

I became so much less patient witch my elder daughter. I could just hear in my head ”just get on with it, it is not that bad, others have it worse, what’s wrong with you” as a response to her deep craving of my love and care. 

Get on with it. 

Get on with it.

Get on with it. 

That’s all i could hear. 

And i kept getting on with it, keeping myself busy, just so I didn’t have to feel. 

Running away from myself. 

Pushing myself with intense, masculine healing, but not actually connecting to the internal felt senses. 

Pretending I was OK. To myself and others. 

I couldn’t show weakness, because it would have been pathetic. 

The narratives rushing through my head were intensely demanding and hurtful. To me and my family. 

Still are sometimes, even though I am getting better and I managed to cry. 

SOMETIMES I HAVE IT ALL TOGETHER…

… And sometimes the days look like anxiety, self-doubt, confusion, panic, pain, restlessness, FOMO.

Today was one of these days. I woke up, not quite rested. Had an allergic reaction after breakfast which rendered me brain fogged, fatigued and struggling to breathe. My period has finally decided to make an appearance after a few days of not being quite sure.

Struggling to get a moment to myself all day booking holidays and cooking and caring for my children. I need time off. I desperately need to get out of London and spend tome in a forest, on the beach. In nature. So I was determined.

I was meant to take breaks and be mindful of the first signs of stress, tiredness and exhaustion .

But I wasn’t and in the evening I broke.

Disregarded my own boundaries.

Skipped shower.

Didn’t do my usual skin and hair care routine.

Didn’t stretch.

Just imploded & abandoned myself.

It’s midnight and here I am, writing this post on the phone, feeling unwell, anxious. It happens.

Tomorrow is a new day.

And each day is a fresh start.

And just because today was further away from my ideal, it doesn’t mean that tomorrow won’t be closer.

Healing is not linear. You’re never really “healed”.

You just learn how to care for yourself, when to let go and love yourself even when you don’t feel lovable. Being kind to yourself even if you don’t rise up to the standard you set for yourself.

Because you are worthy, lovable and you matter.

Warmly, Olivia

MODALITIES & TOOLS TO SUPPORT YOU ON YOUR HEALING JOURNEY

Trauma is complex. It sinks it’s rotten teeth into our thought patterns, emotional response and physiology. You think you’ve processed it and bang! there it is again, making you tremble and hold onto your breath, like if it was the last one you will ever take. Trauma is often described as “too much, too soon” for our physical, emotional and mental state and different things traumatise different people, however we can agree some events will traumatise everybody.

Most of us carry different levels of trauma from our childhood. Parental divorce; neglect; emotional, physical, sexual abuse; shaming; not being seen; not being accepted for who we are. The list goes on. We also carry generational trauma in our genes, but that’s a story for another time.

Trauma can come from not being held enough, listened to enough, respected enough and connected enough.

I’ve been on an intense healing journey since 2011 and I am pretty sure that path never ends, however I’ve gathered a lot of tools and knowledge along the way which I wish to share with you today. Not only through psychotherapy and other modalities, but also through my own training. Read on if you want to know what supported (and keeps supporting) me most during my healing journey.

Full disclaimer is that I am aware that my knowledge is limited, because I only tried some things and there is just so much available. Also, I grow and learn everyday, so what is true for me today, might not be tomorrow, so always trust yourself, make decisions that feel right for YOU and experiment. Below I listed the modalities & tools that helped me the most.

1) Psychotherapy - I’ve been in therapy for a really long time and I don’t intend to stop. The only type I tried is Transpersonal Therapy, because it seems to meet all my needs and help me make sense of my experiences on a physical, emotional, mental, soul and spirit levels. It helps me find my place in this mess we call life and unravel tangled thoughts and overwhelming emotions, while explaining their potential purpose in spiritual terms. I believe that there is more to life than we can experience with our 5 senses and I love exploring these concepts.

2) Somatic Experiencing / NARM - the purpose of these is to release the trauma stored in our bodies, mainly in our nervous and endocrine systems. It is now known how trauma affects the brain and the nervous system, which in turn will have an impact on our endocrine systems (they are so intertwined that they are often referred to as the neuroendocrine system). It is done with breath, movement, visualisation and other exercises. Very powerful tools indeed.

3) Rapid Transformational Therapy - this has been a very powerful tool for overcoming deep seated trauma, where the memories have been completely buried. From what I gather, there is some controversy around this modality, but I found it extremely helpful. The only thing is I wouldn’t recommend it to someone who hasn’t been to therapy and doesn’t know how to hold space for themselves, as heavy shit does come up. It is a form of regression therapy and can help you uncover deeply buried memories and experiences which form your core belief system, which in turn influence you emotional, physical and psychological bodies. Some things you bury deep inside for a reason, so when they come up to the surface it can be very scary and intense - make sure you’ve got good support.

4) Aromatherapy & Herbal Medicine - plants are such powerful healers of the psyche, soma and spirit. I use them in a form of teas, tinctures, macerated oils, essential oils and in powder form. They are wonderful allies on your healing journey and can help ease this difficult process. Make sure you buy your herbs and oils from trusted, ethical suppliers and get organic!

5) Crystals - this is another controversial one, but I simply love them. I love to touch them, meditate with them, put them in my baths, wear as jewellery and create mandalas with. It just another way to connect to the healing power of Mother Earth. Just remember to source your crystals from ethical suppliers.

6) Intuitive non-linear movement - this is one of the most powerful tools I have learned. It has the power to shift your emotions, release stagnant energy stored in your body and help you move through processing trauma. Play some music that makes you feel something and just move. Let your body guide you. Make sounds. Cry. Sing. Scream. Breathe deeply. Witness yourself. It’s liberating and transformative as fuck. Remember to leave your ego behind the door ;) If you need some music inspiration, check out my Spotify playlist here.

7) Functional Medicine & Nutrition - healing is a multilayered affair. We store pain, guilt, shame and trauma in all of our being. It literally writes itself into our DNA and affects physiological function. Our physical health and how it relates to our emotional, mental and spiritual wellbeing in a broad topic, so I am not going to go into the details right now. From experience I know, that you can’t go very far in your emotional healing with an unwell body, and trauma experienced in childhood DOES change your physiology, so working with someone who can bring your body back into balance is a must. Plus ongoing stress depletes your mineral & vitamin reserves!

8) Breathwork - breath is, as you know, vital. Without breathing you die in a matter of minutes. Learn a few basic breath techniques, to help you manage stress, anger, exhaustion. I don’t know how about you, but when I get triggered I literally disassociate and stop breathing. I take a breath in and don’t release it until I get dizzy. Learning how to breathe better and with intention has been transformative. I love a few apps: Pranayama, Calm and Insight Timer.

9) Massage - getting regular massage, is a must, if you can. Admittedly, it has been hard not receiving it (hello, pandemic) and I can feel it in my body. I store tension in my jaw, neck, shoulders and pelvic floor (which affects the abdomen and thighs) and sometimes I struggle to release it myself. And it’s just so relaxing & nourishing to be touched in a intentional way by someone who knows what they are doing. Additionally, massage truly supports you in trauma work. There are massage modalities that are extremely powerful ways of treat women’s health issues, troubles with achieving orgasms, incontinence, scar pain, sexual & obstetric trauma, pelvic pain and more.

10) Myofascial Release - I’ve been learning my body a lot in the past few months very intensely. Observing how it responds to stress and what helps and I begin to observe how everything tightens with stress. It reminds me of egg white being thrown on hot oil or lemon juice. Suddenly from flow and softness everything changes to hard, tight and stagnant to the point of excruciating pain. I can’t afford a massage everyday, the massage I can give myself becomes too much effort and stretches don’t bring any relief. Luckily, I discovered myofascial release, trigger point work, gua sha and rolling. It can be painful in the beginning, but it is extremely relaxing & soothing to my nervous system.

10) Everyday Intentional Movement - yoga, dance, walking, running, cycling, rebounding… Whatever rocks your boat (or body, should I say). Just do it. Start with 5 minutes a day. Movement is key to health. It helps relax your body, build resilience, release happiness hormones, strengthen your heart, slow down ageing & build up strength. DO IT!

These are only a few modalities and techniques & there is plenty more out there. But hopefully it will give you some inspiration. Next on my list are physiotherapy, chiropractic & Bowen technique for my posture (which is a mess!). I know that many of you are already well ahead on your healing journey and I’d love to hear what helped you!

Warmly, Olivia

WHERE TO BEGIN HEALING?

Healing can be complex, overwhelming and heavy. For most of us our experiences will have affected us on physical, emotional, mental and energetic levels. We might struggle with chronic pain, depression, anxiety, inability to express anger, sexual issues or simply be lost, wondering without a purpose. It’s a vicious cycle and it’s best to begin by taking a small step and finding a therapist. It can be really scary to reach out and find help, buy the only way out is through and there is no wrong way to begin.

You deserve to be happy, healthy and to thrive. Yes, you do.

My first step was to attend the Womb & Fertility Massage training with Clare Spink. It was the first time I ever sat in a circle of women. I remember very vividly how my body responded when I stepped through the door on the first day of the training. The tears just begun flowing down my face and didn’t stop for hours. I wasn’t crying. My body was crying tears of heartbreak and joy. Relief. Acknowledgment that I found my path. Finally. I was on my way home.

It was transformative. I will never forget the feeling of being witnessed and held with love. I was frightened, but my heart was joyful. After the training ended, I realised that I must take my life in my hands even more so and not let the trauma I carry dictate who I am any longer. I yearned to be free. So I found a therapist.

A transpersonal therapist. And it changed my life.

Having someone to listen to my thoughts, worries and problems was healing in itself. But my favourite thing was having someone help me see that I am not who I was told I was.

She helped me truly understand myself (or at least begin to), begin to value myself and dismantle the hurtful narratives I had been unconsciously telling myself about who I was & what I deserved and guide me through a processes I beginning to care myself enough to want a better life.

That was my beginning. Everyday, I am grateful for taking the step to reclaim my life.

I have come a long way since that first day of the Womb & Fertility Massage Therapy training, but I will never forget the love, strength and healing I received from this beautiful group of women.

Good luck.

Warmly, Olivia