Clinical publications about perineal massage

Publication Abstracts

We compiled a list of major clinical studies done about perineal massage and its potential benefits.

In all the studies perineal massage was done using the traditional technique (with the thumbs), not with the Perimom Perineal Massager.
The information is presented for informative purposes only.

Cochrane Review

A review of four trials with 2497 women showed that perineal massage, undertaken by the woman or her partner, reduced the likelihood of perineal trauma and ongoing perineal pain. The impact was clear for women who had not given birth vaginally before, but was less clear for women who had.

The authors recommend that: Antenatal digital perineal massage reduces the likelihood of perineal trauma (mainly episiotomies) and the reporting of ongoing perineal pain, and is generally well accepted by women. As such, women should be made aware of the likely benefit of perineal massage and provided with information on how to massage.


Meta analysis of 18 studies show that  Antenatal Perineal Massage can protect the perineum from injury
Childbirth may cause perineal damage like tears or an episiotomy. This review from Poland examined perineal massage, a practice that aims to minimize such injuries. This meta-analysis examine 18 articles using databases like PubMed and Web of Science. 

Meta-analysis of fifty studies show perineal massage is associated with a lower risk of perineal lacerations: A study from Brazil
This researchers from Brazil conducted a meta-analysis consisting of a total of fifty studies with a total of 17,221 participants. Their objective was to investigate the effectiveness of interventions to prevent the occurrence of perineal trauma in a woman during labour.


A systematic meta-analysis about the way perineal massage effects the health outcome on mother in baby in first-time deliveries

The authors of this study investigate the use of perineal massage at the different stages of labor. Seventeen randomized controlled trials involving 3248 women were included in the review. 

Meta-Analysis of 21 studies about Pelvic Floor Muscle Training to prevent perineal trauma
The authors of the study concluded that antenatal perineal
massage, combined with pelvic floor exercises, and even pelvic floor muscle training on its own were effective strategies for the prevention of perineal trauma.

Effect of prenatal perineal massage on postpartum perineal injury and postpartum complications: A Meta-Analysis
The authors concluded that prenatal perineal massage can reduce the risk of perineal injury, the incidence of lateral perineal resection, and the incidence of long-term pain.

Does perineal stretching with instruments increase the elasticity of the pelvic floor muscle?
The authors concluded that pregnant women could benefit from combining perineal massage and instrument-assisted perineal stretching techniques with a short, repeated protocol.


The effectiveness and evidence of ante-natal perineal massage: A study from Spain

The authors concluded that according to current evidence using a prenatal perineal massage during late pregnancy can reduce perineal trauma during childbirth, especially in first-time pregnancies, as well as reduce postpartum pain in women who have not previously had a baby.

How to prevent and repair obstetric tears
The authors reviewed obstetric lacerations that are a common complication of vaginal delivery. They concluded that perineal massage in the third trimester can reduce lacerations in women who are pregnant for the first time.

41-article review of non-pharmacological techniques in pregnancy and childbirth
All the article showed a positive outcome such as reduction of time, anxiety and pelvic floor laceration rates when using non pharmacological techniques in pregnancy and in childbirth.


Effects of perineal preparation techniques on tissue extensibility and muscle strength: a pilot study.
The study found that instrument-assisted stretching and perineal massage both increase PFM extensibility and do not alter the muscle strength of PFMs in pregnant women.

Guidelines developed in accordance with the methods prescribed by the French Health Authority (HAS). 
The paper claims that perineal massage during pregnancy must be encouraged among women who want it. 


An 108-women study from Nigeria evaluates the effectiveness of perineal massage (APM) in reducing perineal trauma.
Perineal massage was shown to reduce the incidence of episiotomy and increase the chances of having an intact perineum after vaginal delivery.

A literature review from Brazil about reducing perineal trauma during labor
The authors of the study concluded that perineal massage by expecting mothers or their partners during the last part of pregnancy is recommended for perineal protection.


Irish and New Zealand Midwives' expertise at preserving the perineum intact: Perspectives on preparations for birth.
The study published in Widwivery included a total of twenty-one consenting midwives, seven from Ireland and 14 from New Zealand. Perineal massage during pregnancy was found to be beneficial to keeping the perineum in tact.

Influence of a pelvic floor training program to prevent perineal trauma: A quasi-randomised controlled trial from Spain.
The study with 466 pregnant women from Spain, published in Midwivery, found that preventing episiotomies and rips in first-time mothers may be as simple as doing pelvic floor exercises and perineal massage.