Along with the vagina, the perineum stretches during labor to create more space for the baby to pass through the vaginal opening. It’s a delicate part of the body, however, and less flexible than the vagina, meaning it can sometimes tear during delivery. 

Although minor tearing of the perineum is common, perineal massage is recommended before childbirth to reduce the risk of severe perineal tears

What Is the Perineum?

Located at the bottom of the pelvis and between the vagina and anus, the perineum is considered part of the pelvic floor. As well as supporting the pelvic floor muscles, enabling childbirth, and contributing to sexual arousal, the perineum also plays a role in supporting urination, defecation, and intercourse.  

What Is Perineal Massage?

Perineal massage is used to gently stretch the tissues, skin, and muscles around the perineum to reduce the risk of tearing during childbirth. Perineal tears that occur during vaginal childbirth typically range from first-degree tears where only the skin of the vaginal walls tear to fourth-degree tears where tearing can extend to the sphincter muscles and rectal lining.  

While first-degree perineal tears are common, mild, don’t require sutures, and heal quickly, the goal of perineal massage is to prevent third and fourth-degree perineal tearing. Because these tears spread to the sphincter muscles and rectal lining, sutures are required, recovery can take up to three months, and long-term complications include incontinence, pelvic organ prolapse, and painful sex often ensue. 

Considered safe after week 34 of pregnancy, regular perineal massage enables this part of the body to stretch more comfortably, thereby lowering the risk of complications or scarring after childbirth. Typically performed by the expecting mother, perineal massage can be carried out using clean hands or a specially designed pelvic massage wand. 

Perineal massage is typically recommended for 5 minutes twice per week to start with and most expectant mothers would be advised to work up to 3-4 times per week for best results. 

Top 5 Benefits of Perineal Massage During Pregnancy

Without regular perineal massage, as many as 80% of women are known to experience perineal tears during vaginal births and approximately 70% of them require sutures. In addition to the pain of a sutured wound, women who experience third and fourth-degree perineal tears are also at a higher risk of infection and bleeding, as well as long-term damage to the perineum and pelvic floor muscles. 

Although perineal massage will not guarantee that long-term complications are avoided, practicing regular perineal massage during the last 4-6 weeks of pregnancy can benefit new mothers in the following ways:  

1. Helps Familiarize First-Time Mothers with the Stretching & Stinging Sensation 

Expectant mothers, particularly first-time mothers, often experience a stinging or burning sensation during labor as the vaginal and perineal skin stretch to allow for the baby’s birth. Although the stinging or burning sensation is much milder during a perineal massage, becoming familiar with it can better prepare mothers for the sensation of labor.  

Becoming used to this feeling can enable expectant mothers to relax during labor, breathe through the burning sensation, and push slowly and gently to avoid tearing. Pushing too much to give birth quicker and relieve the sting of stretching is one of the causes of severe perineal tearing.   

Perineal massage helps you become familiar and comfortable with the area before giving birth. It allows you to relax more during the pushing stage and breathe through this stinging sensation rather than rejecting it or tensing the area.

2. Less Perineal Trauma

Perineal trauma can occur to mothers of any age but is often more common in first-time mothers.  Several studies have shown that regular perineal massage (3-4 times per week for 5 mins) can considerably lower the risk of perineal trauma like third and fourth-degree tears that affect the sphincter, rectum, and pelvic floor muscles. 

Avoiding severe perineal tears also reduces the need for suturing, which helps to avoid infection, excessive bleeding, scarring, and painful scar tissue postpartum. 

3. Prevent the Need for An Episiotomy

Massaging the perineum regularly in the last 4-6 weeks of pregnancy improves the elasticity of the perineal muscles, skin, and tissues. International studies involving expectant mothers in a variety of countries have shown that fewer episiotomies were performed on those who practiced regular perineal massage.  

4. Less Postpartum Perineal Pain

Studies into perineal massage also reveal that women who practice regularly in the month before childbirth generally experience less postpartum pain than those who don’t. Being able to move around and sit with more ease can help new mothers to more easily care for and bond with their baby in the hours, days, and weeks after birth.  

5. Less Risk of Urinary Incontinence & Postpartum Complications

Because the perineum hosts several muscles, tissues, and membranes that enable urination and bowel movements, postpartum complications due to severe perineal tears can include short-term and long-term incontinence.

Other complications that can result from severe perineal tears include pelvic organ prolapse and painful sex due to a lack of support for the pelvic muscles.  

How to Do Perineal Massage?

It’s considered safe to perform perineal massage from week 34, up to 4 times per week for 5 minutes. It can be effective when performed twice per week, however, less tearing is often linked to massaging the perineum 3 to 4 times per week. While a 5-minute massage will suffice for most, it’s a good idea to check with your doctor how long your massage should last to provide benefits.    

  • Before beginning each massage, trim your nails and wash your hands with warm water and unscented soap. 
  • Get comfortable, laying on your back with your head supported, knees bent, and spread apart.   
  • Pour a few drops of water-based lubricant on one of your thumbs and the perineum 
  • (Using a safe and non-irritating lubricant will prevent altering the pH levels of the vagina which could result in infection. Never use fragranced oils, petroleum jelly, or mineral oils on the perineum or vagina)
  • Gently place the thumb inside the vagina as far as the first knuckle and slightly press down toward the rectum
  • Sustaining the gentle pressure against the lower wall of the vagina, make a U-shaped movement with the thumb from left to right and back
  • You should feel a slight stinging or burning sensation as the skin, tissues, and muscles stretch under the pressure of your thumb 
  • Continue massaging the area in a U shape with gentle pressure for 5 minutes

If you’re finding it difficult to reach your perineum in the last month of pregnancy due to your growing belly, consider using a pelvic massage wand for easier access. Some women also prefer the feeling of a lubricated wand to their thumbs, and the gentle vibration on the Intimate Rose pelvic wand provides a more effective deep tissue perineal massage. 

Additional Tips to Prevent Perineal Tears from Pregnancy

To prevent or reduce the severity of perineal tears, birthing experts recommend speaking with your OB/GYN about possible birthing positions. Laying on the back while giving birth is believed to increase the risk of perineal tearing while coming to all fours or laying on your side can help prevent it. 

Breathing the baby’s head out slowly and calmly can also prevent perineal tearing while pushing hard can increase it. 

Eating a balanced and nutritious diet is recommended during pregnancy, not only to nourish both the mother and baby but also to provide nutrients for the skin to enable it to stretch and bounce back more easily. 

Are There Instances Where Perineal Massage Should Not Be Performed?

Perineal massage is considered safe after week 34 of pregnancy, however, there are some situations where it is not recommended.  

  • Expecting mothers who are not yet 34 weeks pregnant should not massage the perineum
  • Women who have been told they have a small cervix are advised to refrain from perineal massage during the last month of pregnancy
  • Expecting mothers who have experienced bleeding during the second trimester are not advised to engage in perineal massage 
  • Perineal massage is not recommended for expecting mothers who have a vaginal infection or for those who suffer from high blood pressure during pregnancy


Perineal massage is an effective way of reducing the risk of severe perineal tears during childbirth and avoiding postpartum complications like incontinence, pelvic organ prolapse, and painful sex. 

Although performing regular perineal massage cannot guarantee that perineal tearing will not occur, it can often prevent the need for an episiotomy and severe tears that require sutures. Perineal massage is also known to make the last stage of labor more comfortable and sometimes faster, as well as reduce postpartum pain so expectant mothers have more time to care for their babies. 

Bearing in mind that every female body and perineum is different, consider speaking with your OB/GYN about how perineal massage is correctly performed, how long you should massage, and how many times per week will suit your unique body. 


Pregnancy, Birth & Baby - Anatomy of pregnancy and birth - perineum and pelvic floor -

Royal College of Obstetricians & Gynaecologists - Perineal Tears During Childbirth -

Cochrane Library - Antentatal perineal massage for reducing perineal trauma -

National Library of Medicine - Perineal massage and training reduce perineal trauma in pregnant women older than 35 years: a randomized controlled trial -

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