Perineal Massage in Pregnancy: Frequently Asked Questions

Perineal Massage Overview

What is the perineum?

The perineum is an anatomical region located between the genitals and the anus in both males and females. It contains various structures such as muscles, blood vessels, nerves, and glands. Read more about what is the perineum.

What is perineal massage?

Perineal massage (perineal stretching) involves massaging the tissue between the vagina and the anus before giving birth. The objective is to condition the birth canal for childbirth, potentially reducing the chances of tearing.

How does perineal massage help during childbirth?

Perineal massage loosens the perineal muscles to open the vagina for childbirth. The massage  potentially makes childbirth easier and quicker than normal. Doing perineal massage does not guarantee you will have no tears and need to stitches during your vaginal birth.

What is antenatal perineal massage? 

Antenatal perineal massage (or in short “perineal massage”) is a massage that helps soften the muscles around the vaginal opening before childbirth to minimize perineal trauma

How often should perineal massage be done?

It is recommended that you perform perineal massage a minimum of three times a week. Each session must be approximately 5 to 10 minutes long.

What are the benefits of perineal massage in pregnancy?

Perineal massage is shown to reduce the risk of perineal trauma during childbirth. Multiple clinical studies have shown it to decrease post-partum pain and speed up post-partum recovery.

What are the drawbacks of perineal massage?

Some believe that perineal massage could actually thicken the perineal skin but there is no scientific evidence to back up this claim.

Who should try perineal massage in pregnancy?

Pregnant women who are at least 35 weeks along should try perineal massage. First-time moms, in particular, may benefit from the massage. But you should talk to your healthcare professional, just to be sure.

How is perineal massage done?

How to do perineal massage depends on if you are doing it on your own or with a partner. Click here to learn more. 

Does perineal massage hurt?

It is normal to feel a slight burning sensation on the first few tries. But it shouldn’t be painful. If it’s painful, stop and seek advice from your doctor.

When should you NOT do perineal massage?

The massage is not recommended if you are under 35 weeks pregnant, if you have placenta previa, or if you have an active vaginal infection such as herpes.

Where can I read more about perineal massage?

There's a lot of content about perineal massage in pregnancy on this site. A good place to start would be by reading the Ultimate Guide for Perineal Massage.

Can perineal massage be done during labor?

In some cases, healthcare providers may perform perineal massage during the labor (during the second stage of labor, when the mother is pushing) to help gently stretch the perineum and reduce the risk of tearing. This has been recommended by healthcare organizations such as the World Health Organization. If your healthcare provider recommends this, add perineal massage oil to your maternity checklist.

Preparing for Perineal Massage

How do I prepare for perineal massage?

The massage is best done after a hot bath. Get in a comfortable position. With clean hands, apply oil on the thumb and fingertips and you’re ready for the massage.

When is the best time to do perineal massage?

The perineal massage should start on the 35^th week of pregnancy. There is no evidence of benefit if you start earlier than that time.

What massage oil should I use for the perineal massage?

The best perineal massage oils are almond oil, vitamin E oil, grape seed oil, and olive oil. Avoid perfumed oils, cream oils, water-soluble lubricants, and petroleum-based oils.

Can perineal massage be done by a partner?

Yes, your partner can do the massage. Because reaching the perineum in the late stages of pregnancy is difficult, a partner’s massage may be easier.

What exercises help stretch the perineum?

Apart from perineal massage, Kegel exercises, deep squats, Valsalva maneuver, and child’s pose (a yoga position) helps prepare the perineum for childbirth. Read more about perineal exercises in pregnancy.

Are there medical devices for self-massaging the perineum?

Epi-No[1], which is marketed in Europe, can be used to prepare the perineum for childbirth. This device is not approved for marketing and sales in the US.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769774/

Perimom is a novel perineal massage tool that helps women do perineal massage completely unaided. The product is the only medical device in the world cleared for perineal massage in the United States and in Europe (FDA-registered in the USA, CE approved in Europe, and TGA approved in Australia).

Does perineal massage induce labor?

There is no clinical evidence to demonstrate that perineal massage induces labor. It does not engage the muscles and therefore does not trigger contractions.

Episiotomy and Vaginal Trauma

Why is perineal massage recommended for pregnant women?

Perineal massage is recommended for pregnant women because it may lower the risk of perineal trauma such as an episiotomy during childbirth.

What is an episiotomy?

Episiotomy is a surgical procedure that involves making a small incision in the perineum to enlarge the vaginal opening as the baby is being pushed.

What are the outcomes of an episiotomy?

An episiotomy could increase the risk of infection, pelvic floor dysfunction, sexual function problems, and incontinence. It could also cause bleeding, pain, and prolonged post-partum recovery.

How does perineal massage prevent episiotomies?

Massaging the perineum muscles regularly makes the skin and muscles elastic, able to accommodate the head of the baby during childbirth.

What are the dangers of vaginal tearing during childbirth?

Vaginal tearing causes hemorrhaging and an increased risk of infection. Extreme cases lead to long-term pain, incontinence, pelvic organ prolapse and recto-vaginal fistula. Read more about the getting through 4th degree perineal tears.

Are there any other methods to reduce vaginal trauma?

There are no assurances of course, but there are a few things that you can do to try to prevent tearing during childbirth or to reduce the severity of tearing.

Perineal Massage: Safety and Effectiveness

Is perineal massage effective?

Multiple clinical studies show that perineal massage helps reduce perineal tearing (especially severe tearing) among first-time mothers. It is associated with less pain 3 months post-partum.

Is perineal massage safe? 

In most cases, perineal massage is considered to be safe. Even if you have a scar from a previous birth, it should be safe to massage the perineum. Talk to your healthcare professional, just to be sure.

Is perineal effective for second pregnancies?

Perineal massage will not reduce the risk of perineal trauma but it will decrease the risk of perineal pain at 3 months among second-time mothers.