What Is Perineal Massage? Benefits, How-To, and When to Start
Pregnancy and childbirth come with a lot of anticipation—and understandably, many mothers-to-be are concerned about labour injuries such as vaginal tearing. One natural technique that can help reduce tearing during vaginal delivery is perineal massage. But what exactly is it, and how do you do it safely?
This guide explores everything you need to know about perineal massage—from its benefits to step-by-step instructions and expert recommendations.
What Is the Perineum?
The perineum is the area between the vaginal opening and the anus. During vaginal delivery, this area can stretch significantly to allow for the baby’s head to pass. In some cases, it may tear or require an episiotomy (a surgical cut).
Perineal massage is a technique used to gently stretch and prepare this tissue for childbirth.
What Is Perineal Massage?
Perineal massage involves manually stretching the skin and muscles of the perineum using fingers or thumbs. It is typically done in the last weeks of pregnancy and can help increase elasticity, improve circulation, and reduce the risk of tearing or needing stitches during birth.
Benefits of Perineal Massage
- Reduces risk of tearing: Studies show perineal massage can lower the chance of needing an episiotomy or experiencing severe vaginal tearing.
- Improves tissue elasticity: Regular massage can increase the flexibility of the perineum, making labour smoother.
- Promotes awareness: Helps women become familiar with their anatomy and prepare mentally for childbirth sensations.
- May reduce pain postpartum: Less trauma during birth may mean less pain and faster healing after delivery.
When to Start Perineal Massage
Most healthcare professionals recommend starting perineal massage at around 34 to 36 weeks of pregnancy. It can be done 3 to 4 times per week for about 5–10 minutes each time. If you’ve had complications, always consult your midwife or doctor first.
How to Perform Perineal Massage: Step-by-Step
Follow these steps to safely perform perineal massage:
- Wash your hands thoroughly and trim your nails to avoid injury.
- Choose a comfortable position: Lying down with knees bent, propped up with pillows, or standing with one leg elevated works well.
- Use a lubricant: Apply a small amount of organic oil (e.g., almond, coconut, or vitamin E oil) to your thumbs or index fingers and the perineum.
- Insert your thumbs about 2–3 cm (1 inch) into the vagina.
- Apply gentle downward and outward pressure toward the anus until you feel a slight burning or stretching sensation.
- Massage in a U-shape: Move your thumbs in a sweeping motion from 3 o’clock to 9 o’clock, slowly and gently.
- Relax and breathe deeply throughout the massage to help the muscles release tension.
- Continue for 5–10 minutes then clean the area gently.
You may ask your partner to assist if reaching the area becomes difficult in later pregnancy weeks.
Is Perineal Massage Safe?
For most women, perineal massage is safe. However, avoid it if you have:
- Placenta previa or bleeding during pregnancy
- Active infections like herpes or yeast infections
- Premature labour risk or have been advised pelvic rest
Always speak with your obstetrician or midwife before beginning.
Does Perineal Massage Work?
According to NHS guidelines and peer-reviewed research, perineal massage can reduce the likelihood of severe perineal tears in first-time mothers. It’s not a guarantee, but it is a beneficial, low-risk practice when done properly.
Common Questions About Perineal Massage
Q1: Does perineal massage hurt?
It may feel slightly uncomfortable or create a burning sensation at first, but it should not be painful. The discomfort usually decreases with consistent practice.
Q2: Can perineal massage replace pelvic floor exercises?
No. While perineal massage targets tissue elasticity, pelvic floor exercises (Kegels) help strengthen muscles. Both can be part of a complete prenatal routine.
Q3: Will perineal massage prevent all tearing?
No, but it significantly reduces the risk—especially of second- and third-degree tears. Other factors like baby’s size, position, and delivery speed also matter.
Q4: Can I use store-bought perineal massage oils?
Yes, as long as they are natural, unscented, and safe for vaginal use. Always check ingredients and do a patch test if unsure.
Q5: Should I stop once I go into labour?
Yes, perineal massage is not performed during active labour. The goal is to prepare the area in advance.
Additional Tips for Labour Preparation
- Consider attending a childbirth education class
- Practice pelvic tilts, squats, and breathing techniques
- Stay active unless your doctor advises rest
- Stay hydrated and maintain a healthy diet
Helpful Internal Links
- Step-by-Step Instructions to Plan Your Pregnancy
- How to Take Care of Yourself During the First Trimester
- What Is Painless Delivery? Epidural and Natural Birth
Final Thoughts
Perineal massage is a simple, natural technique with the potential to reduce trauma during childbirth. While it may not eliminate tearing entirely, it can help prepare your body for the physical demands of labour, reduce fear, and promote healing.
As always, check with your healthcare provider before starting any new prenatal practice. With preparation and support, you can enter childbirth feeling more confident, aware, and in control.