The Ultimate Guide for Perineal Massage in 2026

Perineal massage is recommended by healthcare professionals worldwide

Welcoming a new life into the world is a thrilling experience, particularly for those embarking on motherhood for the first time. If you are planning to give a vaginal birth, thorough preparation is key to navigating this remarkable journey.

What is perineal massage?

There is nothing you want more than for your baby to have a normal childbirth—except maybe less perineal trauma for you. Perineal massage during the late stage of pregnancy has been used for generations to prepare the perineum for delivery. It loosens the tight perineal muscles, which softens and flexes the birth canal.

Perineal massage is recommended by healthcare midwives, pelvic floor physiotherapists, and doulas as well as medical organizations. Perineal massage can be done by you or a partner.

The recommended time to start perineal massage is anytime from the 34th or 35th week of your pregnancy.

Your perineum and childbirth

The perineum is the area between the vagina and the anus. This diamond-shaped area is comprised of a thin layer of subcutaneous tissue (aptly called perineal muscles) and skin. The perineum connects with the pelvic floor muscles, which support the pelvic organs such as the bowels and bladder. A damaged perineum may weaken the pelvic floor muscles.

Perineum anatomy

During a vaginal birth, the perineal muscles stretch and expand to give way to the baby. Perineal massage is done to make this area more supple and ready for birth.

Use the right oil for you

Lubrication makes the massage more comfortable. Lubricants soften and hydrate the perineum tissues. The best perineal massage oils are mild, all-natural oils. Opt for oils that reduce inflammation and improve skin elasticity. Some types of oils could also reduce the risk of scarring. We highly recommend these oils:

- Sweet almond oil
- Olive oil
- Vitamin E oil

Avoid oils that could increase your risk of vaginal infections. Avoid water-soluble lubricants that contain high levels of salt/ion. These products could irritate the delicate vaginal tissues. Cream products, essential oils, regular body massage oil, or perfume oils are not recommended. Avoid using petroleum-based oils like petroleum jelly, mineral oil, or baby oil.

The modern way to do perineal massage with Perimom

The Perimom Perineal Massage tool was designed to empower you to do perineal massage completely on your own, whenever you want. You can easily reach your perineum and start conditioning it for childbirth within minutes. See the following diagrams of how to do perineal massage with Perimom.

Sit and relax

Sit and relax

Sit comfortably in a semi-reclined position on a clean towel.

Perineal massage with Perimom hold

Hold Perimom

Hold the top end of Perimom's firmly in your right hand.

Perineal massage with Perimom Pour oil

Pour massage oil

Oil the smooth concave bottom tip of the Perimom.

Perineal massage with Perimom - Insert

Insert and stroke

Insert and start stroking the perineal area with the smooth rounded bottom of the device

Perineal massage with Perimom do the massage

Massage Your Perineum

Massage your perineum for 5-10 minutes. Repeat the massage three times a week, but consult with your healthcare professional.

Traditional ways to perform a perineal massage


On your own

Reaching the perineum on your own is a challenge when the baby bump is in the way.
However, it’s possible if you are flexible enough and have patience.

See the following perineal massage diagram to learn how to do it on your own:

Traditional perineal massage on your own 1

Step 1
Prepare

Get into a comfortable position. If you are lying down, prop your legs up with pillows for support and keep the knees bent. If you are sitting down, try squatting down with your back to the wall for support.

pour oil

Step 2
Apply oil

Pour about a teaspoonful of your favorite massage oil and apply all over the fingertips and thumbs. Place one or both thumbs on the back wall of the vagina with your forefingers resting on the buttocks. 

perineal massage on you own insert fingers

Step 3
Insert fingers

Press and move the fingers down towards the anus in a rhythmic, gentle movement. Insert your index or middle finger/s into the vagina, resting the palms against the inside leg.

perineal massage on you own massage with thumbs

Step 4
Massage

If you are massaging the perineum for the first time, imagine that your vaginal opening is a clock face. Pull your two fingers down to 6 then stretch outwards to 3 using gentle pressure. Repeat 20 to 30 times then repeat on the opposite side, 6 to 9.


With a partner

Perineal massage can be done by a partner. Studies have shown that in some cases this brings couples closer, but in others it causes embarrassment and tension.

See the following perineal massage diagram to learn how to do perineal massage if you have a partner who can help:

Perineal Massage with Partner

Step 1
Prepare

Your partner sits across from you.

pour oil

Step 2
Apply oil

Before the massage they should apply about a teaspoonful of massage oil over the fingertips and thumbs.

perineal massage on you own insert fingers

Step 3
Insert fingers

The partner then places one or both index fingers on the back wall of the vagina.

perineal massage on you own massage with thumbs

Step 4
Massage

The fingers are pressed and moved down towards the anus in a rhythmic, gentle movement. Continue for about 5-10 minutes each time.

Perineal Massage Tips and Techniques

Get comfortable

Getting comfortable helps you reach the perineum easily. This is especially true when you are heavily pregnant and you’re doing the massage yourself. Being in a comfortable position before and during the massage is key to relaxing the perineal muscles. Since you are in a comfortable position, you are less tense, which relaxes the muscles.

Some women are more comfortable having the massage while lying down, others prefer sitting up. You could also try standing up and elevating one foot on a chair during the massage. Choose the position that is most comfortable for you.

Feel the stretch (it shouldn't hurt though)

As you massage the insides of the vagina, you will feel the skin outside of the vagina stretching. Use gentle pressure as you massage the perineum. Focus on the rhythmic motions of the fingers and breathe in and out deeply to relax and stretch the muscles. It’s normal to feel a slight burning sensation during the first few tries. But the massage shouldn’t be painful.

Use Warm Water

Warm water helps to soften and loosen taut muscles. You can take a warm bath during or before the massage or apply a warm compress to the perineum for 10 minutes before the massage.

For traditional massage: Trim your nails and wash your hands

Because you are aiming to massage the insides of the vagina cleaning your hands thoroughly is a must. Trimming your nails prior to the massage is a must to avoid injury.

If you are using the Perimom Perineal Massager, wash the device thoroughly with warm water and soap.

Get a Mirror

Giving yourself a perineal massage for the first time might seem daunting but doing it in front of the mirror helps because you can see exactly what you are doing.

What the research says about perineal massage

Multiple major clinical reviews have examined the effectiveness of antenatal perineal massage. A Cochrane review of four trials with 2,497 women concluded that perineal massage performed in late pregnancy reduces the likelihood of perineal trauma and ongoing perineal pain, particularly in first-time pregnancies. The Cochrane authors explicitly recommend that women be made aware of these benefits.

A 2023 Brazilian meta-analysis of 50 studies and 17,221 participants reported a lower risk of perineal lacerations. A 2023 Polish meta-analysis of 18 studies reached similar conclusions. Multiple 2022 reviews report that prenatal perineal massage decreases the severity of perineal trauma — meaning fewer severe third- and fourth-degree tears, which are the tears that require extensive stitching and prolonged recovery.

A 2024 study additionally found that prenatal perineal massage was associated with reduced fecal and flatus incontinence three months postpartum.

For the full publication list, see our Literature page.

Frequently asked questions

What does a perineal massage do?

Perineal massage aims to prepare the birth canal for childbirth, potentially reducing the likelihood of tears. It is a technique that involves gently stretching the area between the vagina in the weeks before giving birth.

Why should I massage my perineum?

Many studies show that perineal massage reduces perineal trauma during childbirth (especially in first-time pregnancies). Studies also suggest it may reduce the amount of pain after birth.

Does perineal massage actually prevent tearing?

Yes — clinical evidence consistently supports it. A Cochrane review of 2,497 women found perineal massage reduces perineal trauma and ongoing pain. Larger meta-analyses confirm fewer severe (3rd–4th degree) tears. See our Literature page for the full publication list.

When should I start perineal massage?

Healthcare organizations and professionals recommend that you should start doing perineal massage between the 34th and 35th week of pregnancy.

Should I start perineal massage before 34 weeks?

There is no evidence that supports starting perineal massage earlier than the 34th week of pregnancy.

When is too late for perineal massage?

It is never too late, provided your pregnancy is normal. Ask your healthcare provider just to be sure.

How long should a perineal massage last?

The recommended frequency of perineal massage is three times per week. The length of each session should be between 5 and 10 minutes.

What's the best tool for perineal massage?

A good tool is thumb-shaped (not wide), curved to reach around the bump, and ergonomic for one-handed use. Wide pelvic wands are designed for general pelvic work, not perineal-specific massage. Perimom was built exclusively for this — thumb-shaped tip, curved handle, integrated oil channel, used by 45,000+ women since 2019.

What if I can't reach my perineum because of my bump?

Reaching the perineum in the third trimester is one of the most common difficulties. With a large bump, your thumbs may not reach far enough — especially from week 35 onwards. A curved tool like Perimom extends your reach (22 cm length, angled tip) and lets you do the massage on your own.

Can I do perineal massage by myself, without a partner?

Yes. Many women prefer solo practice — for privacy, for control, or because their partner is uncomfortable. A solo-friendly tool with a curved handle and thumb-shaped tip (such as Perimom) makes self-application practical even with a late-stage bump.

What oil should I use for perineal massage?

Use a natural, unrefined (cold-pressed) plant oil — not refined or processed. Recommended: sweet almond, extra virgin olive, organic coconut, grape seed. Avoid baby oil, mineral oil, perfumed oils, warming or water-soluble lubricants. See our oils article.

How deep do you go for perineal massage?

Place your thumbs or the tip of the Perimom perineal massage tool up to 2 inches (5 centimetres) inside your vagina.

What is the U-shape technique?

Insert your thumb (or tool tip) about 2 inches/5 cm inside the vagina, apply gentle downward pressure toward the rectum, then sweep slowly outward in a U-motion — first to one side, hold 30–60 seconds, then the other. Repeat for 3–5 minutes per session.

Does perineal massage hurt? What should it feel like?

Perineal massage should not be painful. Many women describe a stretching, mild pressure, or warmth sensation — especially during the first sessions. If you feel pain at any point, stop and consult your midwife, OB-GYN, or pelvic floor physiotherapist.

How do I know if my perineal massage is working?

Your perineum, including the skin and muscles in the area, will become more flexible if you are doing it correctly. This should happen within a couple of weeks of beginning the massage.

Who shouldn't do perineal massage?

You should not do perineum massage if you are in a high-risk pregnancy group, have pre-term contractions, are at risk for pre-term labor, have placenta previa, an active herpes outbreak or other vaginal/STD infection, vaginal bleeding, risk for placental abruption, are pregnant with multiple fetuses where the lower one is in breech, or have undergone a surgical procedure in the perineal region. Talk to your healthcare professional before starting.

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Resources

1. https://www.motherlylove.co.uk/the-importance-of-massaging-the-perineum-in-pregnancy/
2. https://theconversation.com/what-we-know-about-perineal-tearing-and-how-to-reduce-it-during-childbirth-6321

3. https://www.vaginacoach.com/blogs/news/15058045-5-tips-for-perineal-healing-postpartum

4. https://www.ncbi.nlm.nih.gov/pubmed/1130098

5. https://www.bellybelly.com.au/pregnancy/perineal-massage/

6. https://www.beingtheparent.com/relaxin-hormone-during-pregnancy/

7. https://www.ncbi.nlm.nih.gov/pubmed?term=16437520

8. https://www.ncbi.nlm.nih.gov/pubmed/1007613

9. https://www.ncbi.nlm.nih.gov/pubmed?term=1643752

10. https://www.ncbi.nlm.nih.gov/pubmed?term=16437520

11. https://www.cochrane.org/CD005123/PREG_antenatal-perineal-massage-for-reducing-perineal-trauma

12. https://www.ncbi.nlm.nih.gov/pubmed/2960758

13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1403252/

14. https://www.ncbi.nlm.nih.gov/pubmed/1007613

15. https://extranet.who.int/rhl/topics/preconception-pregnancy-childbirth-and-postpartum-care/care-during-childbirth/care-during-labour-2nd-stage/who-recommendation-techniques-preventing-perineal-trauma-during-labour