Perineal Massage in Pregnancy: Frequently Asked Questions
Perineal massage is a gentle stretching technique done in the last weeks of pregnancy to condition the perineum — the tissue between the vaginal opening and the anus — for the stretching of childbirth. It's usually started around week 34–35, done about 3 times a week for 5–10 minutes, and is discussed by healthcare bodies including the World Health Organization. Always check with your provider before starting anything new.
Perineal massage overview
What is the perineum?
The perineum is an anatomical region between the genitals and the anus in both males and females. It contains muscles, blood vessels, nerves, and glands. Read more about what the perineum is.
What is perineal massage?
Perineal massage (or perineal stretching) involves massaging the tissue between the vagina and the anus before birth. The aim is to condition the area and make it more supple for childbirth.
How does perineal massage work during childbirth?
It softens and loosens the perineal muscles so the area can stretch more readily as the baby is born. Doing perineal massage does not guarantee you'll have no tears or need stitches during a vaginal birth.
What is antenatal perineal massage?
Antenatal perineal massage (or simply "perineal massage") is a massage that helps soften the muscles around the vaginal opening before childbirth, as part of birth preparation.
How often should perineal massage be done?
A minimum of about three times a week, with each session roughly 5–10 minutes.
What does perineal massage actually do?
It conditions the perineal tissue to become more supple and helps you get familiar with the stretching sensation beforehand. The practice is examined in clinical research and discussed by healthcare bodies; findings vary and there are no guarantees, so discuss it with your provider.
Are there any drawbacks?
Some have suggested perineal massage could thicken the perineal skin, but there's no scientific evidence to support that claim.
Who should try perineal massage in pregnancy?
Generally people who are at least 35 weeks along; first-time mothers in particular may find it useful. Talk to your healthcare professional to be sure.
How is perineal massage done?
How to do perineal massage depends on whether you're doing it alone or with a partner — see the step-by-step guide.
Does perineal massage hurt?
A slight burning or stretching sensation is normal the first few times, but it shouldn't be painful. If it's painful, stop and seek advice from your doctor.
When should you NOT do perineal massage?
It's not recommended if you're under 35 weeks, if you have placenta previa, or if you have an active vaginal infection such as herpes. Talk to your healthcare provider, just to be sure.
Can perineal massage be done during labor?
In some cases a healthcare provider may massage the perineum during the second stage of labor (when the mother is pushing) to help it stretch gently. This is discussed by the World Health Organization. If your provider recommends it, add a perineal massage oil to your maternity checklist.
Preparing for perineal massage
How do I prepare for perineal massage?
It's best done after a hot bath. Get into a comfortable position, and with clean hands apply oil to your thumb and fingertips.
When is the best time to start?
Around the 35th week of pregnancy. There's no evidence of benefit from starting earlier than that.
What massage oil should I use?
Good perineal massage oils include almond oil, vitamin E oil, grapeseed 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. Because the perineum is hard to reach late in pregnancy, a partner's help may be easier.
What exercises help prepare the perineum?
Alongside massage, Kegel exercises, deep squats, the Valsalva maneuver, and child's pose (a yoga position) can help. Read more about perineal exercises in pregnancy.
Does perineal massage induce labor?
There's no clinical evidence that perineal massage induces labor. It doesn't engage the muscles that trigger contractions.
Episiotomy and vaginal tears
Why is perineal massage suggested for pregnant women?
It's suggested as a way to help condition the perineum for the stretching that happens during childbirth.
What is an episiotomy?
An episiotomy is a surgical procedure that makes a small incision in the perineum to enlarge the vaginal opening as the baby is being born.
What are the outcomes of an episiotomy?
An episiotomy could increase the risk of infection, pelvic floor dysfunction, sexual function problems, and incontinence. It can also cause bleeding, pain, and a longer recovery.
How is perineal massage thought to help with the perineum?
Massaging the perineal muscles regularly helps the skin and muscle become more elastic, so the area is better able to accommodate the baby's head during childbirth.
What are the dangers of vaginal tearing during childbirth?
Vaginal tearing can cause bleeding and an increased risk of infection. Extreme cases can lead to long-term pain, incontinence, pelvic organ prolapse, and recto-vaginal fistula. Read more about getting through 4th-degree perineal tears.
Are there other things that may help during birth?
There are no assurances, but there are a number of approaches that may help — see our guide to things that may help during childbirth.
Perineal massage: safety and effectiveness
Is perineal massage effective?
Perineal massage is discussed by the WHO and examined in clinical reviews, particularly for first-time mothers. Findings vary and there are no guarantees, so it's best discussed with your provider.
Is perineal massage safe?
In most cases it's considered safe, even if you have a scar from a previous birth. Talk to your healthcare professional to be sure.
Is perineal massage worthwhile for second pregnancies?
The evidence is more limited for second-time mothers. If you've given birth before, discuss with your provider whether it's worth including in your preparation. See further reading.
