Perineal massage has been linked to a reduced risk of severe tearing (3rd and 4th degree tears) for those giving birth for the first-time. At this point it’s not known if it decreases the chances of a spontaneous tear or the need for an episiotomy.
If you have given birth vaginally before, perineal massage can still be helpful as it’s been shown to decrease perineal pain at three months postpartum.
What is perineal massage?
Perineal massage is a process of applying pressure to the pelvic muscles, by inserting one or two clean fingers into the vagina a couple inches and applying pressure. While there’s still more we need to learn about exactly how often and how long it should be done for maximum effectiveness, a couple times a week for 5 minutes is a good rule of thumb. You can start at week 34 of pregnancy.
What’re the benefits?
This practice has the most significant benefits during your first pregnancy. It decreases the relative risk of perineal trauma by 10%. It also decreases perineal pain after birth and can also be done during labor, to decrease the severity of a tear.
How do I start perineal massage?
You can either massage your perineum yourself, or ask your partner to help. Do it after a shower or bath, when you’re feeling relaxed and comfortable.
Get some lubricant, sit comfortably, and insert a clean finger or thumb a couple inches into your vagina, gently stretching the skin to the side, then toward the back of the body, then toward the other side. Continue this U movement for 5 minutes. This will help prepare your muscles and tissues for the stretching that will happen during birth.
It can be helpful to use a handheld mirror to see what you’re doing. You may feel a bit of burning or a stretching feeling at first, but perineal massage should not hurt.
This content was reviewed by Dr. Lisa Hickman and Dr. Katie Propst. Dr. Hickman runs the Childbirth Pelvic Floor Disorders Clinic at The Ohio State University Wexner Medical Center. Dr. Propst runs the Postpartum Care Clinic at Cleveland Clinic.
- Jen Gunter. “Massaging Away a Potential Complication of Birth?” The New York Times. January 31, 2019. https://www.nytimes.com/2019/01/31/well/live/massaging-away-a-potential-complication-of-birth.html.
- Healthwise Staff. “Childbirth: Perineal Massage Before Labor.” Healthwise. University of Michigan Health. October 8, 2020. https://www.uofmhealth.org/health-library/tn10339.
- Sharon Muza. “What Is the Evidence for Perineal Massage During Pregnancy to Prevent Tearing?” Lamaze International. Lamaze International. December 18, 2012. https://www.lamaze.org/Connecting-the-Dots/what-is-the-evidence-for-perineal-massage-during-pregnancy-to-prevent-tearing.