Perineal massage: Benefits and how to do it

Reviewed by: Dr. Fatimah Khan

5 min read

Mar 28, 2025

Preparing for childbirth involves various strategies to ensure a smoother delivery and recovery. One technique gaining attention is perineal massage, which focuses on stretching and preparing the perineum—the area between the vagina and anus—for childbirth. Let's explore the benefits of perineal massage and how to perform it effectively.

What is Perineal Massage?

Perineal massage involves gently stretching and massaging the perineal tissues in the weeks leading up to childbirth. This practice aims to increase the elasticity of the perineum, potentially reducing the risk of tearing during delivery.

Benefits of Perineal Massage

Incorporating perineal massage into your prenatal routine offers several potential benefits:

Reduced Risk of Perineal Trauma: Regular perineal massage has been linked to a decreased likelihood of perineal tears and the need for episiotomies during childbirth. A comprehensive analysis found that women who practiced antenatal perineal massage experienced significantly lower rates of episiotomies and perineal tears, particularly severe third- and fourth-degree tears.
Decreased Postpartum Perineal Pain: By minimizing trauma during delivery, perineal massage may lead to less postpartum discomfort. The same analysis noted better wound healing and reduced perineal pain in women who engaged in perineal massage.
Shortened Second Stage of Labor: Some studies suggest that perineal massage can reduce the duration of the pushing phase during labor, potentially leading to a more efficient delivery process.

How to Perform Perineal Massage

Starting perineal massage around the 34th week of pregnancy is commonly recommended. Here's a step-by-step guide:

Prepare: Wash your hands thoroughly and ensure your nails are trimmed to avoid discomfort or injury.
Choose a Comfortable Position: Find a relaxing spot where you can sit or recline comfortably. Some women prefer to prop one foot up on a chair or sit in a warm bath to help relax the perineal area.
Lubricate: Apply a natural oil, such as almond or olive oil, to your thumbs and the perineal area to reduce friction.
Insert Thumbs: Gently insert your thumbs about 3-5 cm (approximately 1-2 inches) into your vagina.
Massage: Press downward toward the anus and then outward toward the sides of the vagina in a U-shaped motion. You should feel a gentle stretching sensation but not pain.
Hold and Repeat: Hold the stretch for about one minute, then relax. Repeat this process for approximately 5 minutes.
Frequency: Aim to perform perineal massage daily or as often as possible in the weeks leading up to your due date.

Partner Involvement

If you feel comfortable, your partner can assist with perineal massage. They can use their index and middle fingers to apply gentle pressure and perform the same U-shaped stretching motion. Open communication is essential to ensure the pressure remains within your comfort level.

Tips for a Successful Perineal Massage

Relaxation: Engage in deep breathing exercises to help relax your pelvic muscles during the massage.
Consistency: Regular practice enhances the effectiveness of perineal massage.
Communication: If involving a partner, maintain open dialogue to ensure comfort and effectiveness.
Hygiene: Always use clean hands and consider using a mirror initially to become familiar with the area.

When to Avoid Perineal Massage

Consult with your healthcare provider before starting perineal massage, especially if you have:

A history of preterm labor.
Placenta previa or other placental complications.
Active vaginal infections.

Final Thoughts

Perineal massage is a proactive approach to prepare your body for childbirth, potentially reducing the risk of perineal trauma and enhancing postpartum recovery. By dedicating a few minutes each day in the final weeks of pregnancy, you can increase the elasticity of your perineal tissues and approach labor with greater confidence. Always discuss any new practices with your healthcare provider to ensure they align with your individual health needs.

References:

Pregnancy Birth and Baby. "Perineal massage." https://www.pregnancybirthbaby.org.au/perineal-massage
Royal College of Obstetricians and Gynaecologists. "Reducing your risk of perineal tears." https://www.rcog.org.uk/for-the-public/perineal-tears-and-episiotomies-in-childbirth/reducing-your-risk-of-perineal-tears/
My Expert Midwife. "How To Do Perineal Massage To Prevent Perineum Tearing." https://myexpertmidwife.com/blogs/my-expert-midwife/why-you-should-do-perineal-massage-and-how-to-do-it