During childbirth, the perineum, pelvic floor muscles, and vagina stretch to their limits to allow the baby’s head and shoulders to pass through the vaginal opening. Located between the vagina and anus, the perineum is not the most flexible part of the body and can greatly benefit from massage during pregnancy to prevent severe tearing. 

What Is Perineal Tearing? 

The perineum is considered part of the pelvic floor and acts as a support for the pelvic floor muscles. As the part of the body between the vagina and anus, the perineum hosts a group of muscles, membranes, connective tissues, and nerves that support bladder and bowel movements, sex, and childbirth. 

Without perineal massage, the perineum is known to tear in as many as 80% of first-time mothers giving birth vaginally. Although some tears are mild, 70% require sutures. 

First and second-degree perineal tears are considered mild, affect only the vaginal muscles and generally heal without sutures within a few weeks after birth. Third and fourth-degree perineal tears tend to involve a tear that involves through the sphincter muscle and rectal lining, require sutures, and can take a few months to heal fully. 

Third and fourth-degree perineal tears heal within a few months after childbirth, but they can result in long-term complications like painful scar tissue, incontinence, dyspareunia (pain during sex), and pelvic organ prolapse. 

To avoid severe perineal tears during childbirth, OB/GYNs and pelvic health experts recommend massaging and gently stretching the perineum for the last few weeks of pregnancy. 

Does Perineal Massage Prevent Tearing During Pregnancy?

When practiced correctly and consistently in the last few weeks of pregnancy, perineal massage can significantly prevent severe tearing. 

Bearing in mind that the perineal and vaginal muscles are stretched during the last stages of labor, some mild perineal tearing may still occur even after practicing perineal massage.

However, massaging the perineum regularly after week 34 of pregnancy is known to help prevent third and fourth-degree tears, as well as long-term postpartum complications.

The following benefits are also linked to perineal massage during pregnancy:

Gets First-time Mothers Used to the Stretching Sensation 

Practicing perineal massage helps first-time mothers get used to the stretching sensation they will experience during delivery as the vaginal and perineal skin stretch past their limits. Even though the stinging sensation felt during a perineal massage is far slighter than the sensation during labor, becoming used to is helpful. 

Being accustomed to this stinging feeling of skin stretching can help first-time mothers remain calm, breathe, and push slowly to avoid tearing. Not understanding this stinging sensation often causes first-time mothers to push too hard, birth too fast, and suffer severe perineal tearing in the process.  

Prevents An Episiotomy

Traditionally, an episiotomy was carried out to prevent third and fourth-degree perineal tears when the perineum had stretched to its limit. Recent research, however, has proven that rather than prevent severe perineal tearing an episiotomy can worsen it. Since the emergence of these statistics, an episiotomy is only performed when either the mother or the baby is in distress. 

Not pushing enough during childbirth, or pushing too hard or too quickly, can put the baby and/or mother under duress to the point that an episiotomy could be required. On the other hand, studies involving expecting mothers in a variety of countries have shown that far fewer episiotomies were performed on those who practiced regular perineal massage.  

Less Vaginal & Perineal Trauma

Due to the excessive stretching that is required from the vagina and perineum during childbirth, trauma in the form of tearing, sutures, and pain can be reduced and often prevented with the help of perineal massage. Less severe perineal tears during childbirth mean that sutures, excessive bleeding, scar tissue, and the risk of infection are all lower in the aftermath of delivery.

Less postpartum pain and discomfort means new mothers can more easily bond with and care for their newborns. 

Reduced Risk of Incontinence & Postpartum Complications

The perineum hosts an important group of muscles, membranes, nerves, and tissues that support the bladder and bowel. Third and fourth-degree perineal tears during childbirth can often result in urinary and/or fecal incontinence. Even though this is temporary for many, severe perineal tears can cause long-term incontinence for others. 

The perineum also supports the pelvic floor muscles, which in turn support the pelvic organs and the vagina. Because severe perineal tears result in a lack of support for the pelvic floor muscles, pelvic organ prolapse and pain during sex can become long-term issues if the perineum does not properly heal. 

Regular perineal massage in the last few weeks of pregnancy can help to avoid long-term complications like these. 

How to Do Perineal Massage?

It’s generally considered safe to perform perineal massage from week 34, up to 4 times per week for 5-10 minutes. Although it is known to be effective when performed twice per week, research shows that less tearing is often linked to massaging the perineum 3 to 4 times per week. A 5-minute perineal massage is generally sufficient, but it’s a good idea to check with your doctor as to how long your massage should last to provide the required benefits.    

Should Perineal Massage Ever Be Avoided?

Even though perineal massage is recommended after week 34 of pregnancy for most women, there are some situations where it is not considered safe. These include: 

  • When you have experienced bleeding during the second trimester  
  • When you have a vaginal infection 
  • When you have high blood pressure

These are typically situations that expecting mothers will be made aware of by their OB/GYN. That said, it’s wise to check before beginning with perineal massage. 

Other Tips that Help Prevent Perineal Tearing 

Birthing positions are incredibly important to avoid perineal tearing. Lying on your back while giving birth can increase the risk of perineal tearing, for instance, and lying on your side or coming to all fours can help reduce it. Speak with your OB/GYN about the best birthing position for you. 

Eating a healthy, nutritious, and balanced diet is not only nourishing for the baby but also for the expecting mother’s body and skin. Healthy skin tends to stretch and heal more easily. 

Take birthing and breathing classes to understand what happens to the body during labor and how your breathing can help you through it. Learning to breathe through contractions and push the baby’s head and shoulders slowly through the vaginal opening can go a long way toward preventing perineal tearing. 


Massaging the perineum regularly after week 34 of pregnancy helps prevent severe third and fourth-degree perineal tearing during childbirth. Although mild vaginal tears might still occur, perineal massage is known to reduce the risk of severe tears into the sphincter muscle and rectal lining more than any other preventative therapy for childbirth.  

In addition to preventing severe perineal tearing, regularly massaging the perineum either with the thumbs or a pelvic massage wand, can eliminate postpartum incontinence and pelvic organ prolapse, as well as uncomfortable scar tissue that can result in pain during sex.  


Pregnancy, Birth & Baby - Anatomy of pregnancy and birth - perineum and pelvic floor - https://www.pregnancybirthbaby.org.au/anatomy-of-pregnancy-and-birth-perineum-pelvic-floor

Royal College of Obstetricians & Gynaecologists - Perineal Tears During Childbirth - https://www.rcog.org.uk/for-the-public/perineal-tears-and-episiotomies-in-childbirth/perineal-tears-during-childbirth/

Cochrane Library - Antentatal perineal massage for reducing perineal trauma - https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005123.pub3/full

National Library of Medicine - Perineal massage and training reduce perineal trauma in pregnant women older than 35 years: a randomized controlled trial - https://pubmed.ncbi.nlm.nih.gov/30941442/


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