Perineal massage during pregnancy

Written by Jessica McKinney, PT, MS and Samantha Pulliam, MD and sponsored by

Have you heard about perineal massage or wondered if it has any benefits to improving your labor and delivery? There’s a lot of mixed and misinformation out there, so here’s the latest research and expert opinion.

So what exactly is perineal massage?

It’s a gentle massage and sustained stretch to the perineum – the area between the vaginal and anal openings. You can do it yourself by placing the thumbs (clean hands, of course; lubricant optional) about one to two inches inside the vagina and pressing down towards the anus and to the right and left sides, until a stretch or light burning sensation is felt. Your partner can also learn to do this. Typically, it’s done for about five minutes, once or twice a week, during the last four to six weeks of pregnancy. Perineal massage is generally safe for most women, but of course, you always want to speak with your health care provider before starting a program of perineal massage, especially if you have had any complications during your pregnancy.

What are the benefits?

If you’re anticipating your first vaginal birth, perineal massage can help reduce the chances of perineal trauma that might require stitches. And for those who have never had a vaginal delivery, it lowers the chances you’ll need an episiotomy – an incision or cut into the perineum that is usually done if the baby is stuck or in distress. For those who have had a previous delivery, perineal massage is associated with less pain reported at three months after delivery. What’s interesting about this research is that performing massage more often than twice per week in the final month of pregnancy, did not have any added benefit – more isn’t always better! We’re not quite sure why this is the case, but this is why, for now, it is recommended to do this massage once or twice a week and not more frequently.

Perineal massage is safe for most expectant mothers. While it may be a little uncomfortable, it should not cause pain or irritation to the skin. Perineal massage can help you to become familiar with this part of your body and the burning or stretching sensations you may feel during delivery. By learning to relax and breathe comfortably while practicing this massage, you can prepare your body for the birth experience.

About the authors:
Ms. McKinney is a physical therapist and has specialized in pelvic and women’s health throughout her career. Her background includes women’s health education, advocacy, and business and program development in the US as well as in low-resource global health settings. She currently serves as Vice President of Medical Affairs and Clinical Advocacy at Renovia Inc. 

Dr. Pulliam a fellowship-trained and board certified urogynecologist, a subspecialty of medicine focused exclusively on female pelvic health. She has been in clinical and leadership positions at Massachusetts General Hospital and the University of North Carolina (Chapel Hill), as well as within the American Urogynecologic Society, and she currently serves as the Chief Medical Officer at Renovia Inc. 

  • Nurse-Midwives AC of. Perineal Massage in Pregnancy. Journal Midwifery Women’s Heal. 2016;61(1):143-144.
  • Seehusen DA, Raleigh M. Antenatal Perineal Massage to Prevent Birth Trauma. Am Acad Fam Physicians Cochrane Clin Putt Evid into Pract. 2014;89(5):335-336.
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