TLDR: During birth, your perineum, aka the area between your vagina and anus, can tear to accommodate your baby in the birth canal—or a doctor can cut it. Neither is ideal, but perineal massage is an easy technique you can start toward the end of your pregnancy to help prevent this scenario and ease your postpartum recovery.
Pregnancy brings with it so many different experiences. Your body is made to do amazing things during birth, and the perineal area is no exception. If you’re unfamiliar with the term, the perineum is the area behind your vagina down to the rectum. It’s resilient and designed to stretch to help make sure your baby makes it safely out of the birth canal.
However, damage to your perineum during birth is extremely common—about 85% of women are affected by perineal trauma1 , according to My Expert Midwife. But there’s an easy trick you can use to increase the flexibility of the perineal area called perineal massage. Perineal massage is a well-researched early prevention technique2 that you can use to reduce the risk of tearing and episiotomy.
Dr. Lauren Demosthenes, Senior Medical Director with Babyscripts, adds that tearing is “more common in the first vaginal delivery,” so if you’re a first-time mom, perineal massage may make sense for you.
Read on to find some great tips on how to do a perineal massage and how to make this practice an ongoing part of your pregnancy self-care or partner bonding in just a couple minutes a day.
What is a Perineal Massage?
A perineal massage involves using your hands and massage gel or oil to work and loosen the perineum to help provide more flexibility when it’s time for the baby to come down the birth canal. This massage does not induce labor, and it’s a safe and helpful technique that you can start doing from the time you’re 34 weeks pregnant. It only takes a few minutes, and it’s definitely something worth adding to your routine toward the end of your pregnancy.
What are the Benefits of Perineal Massage?
Dedicating time to perineal massage from 34 weeks of pregnancy until delivery can help prevent tears during a vaginal delivery. Regularly performing perineal massage—Dr. Demosthenes recommends about 3-4 times per week—helps create more flexibility within the skin of the perineum, so it stretches further during labor.
This helps decrease the likelihood of natural tearing and/or the need for an episiotomy, thus decreasing postpartum healing time and reducing postpartum pain and discomfort.
How to do a Perineal Massage
There are five steps to a perineal massage. You can perform all the steps in about five minutes or less per session, and you can do it yourself or enlist your partner, if you have one, to help.
Step 1: Wash your hands
The first step is essential and simple: hand hygiene. Wash your hands thoroughly and make sure your nails are cut short to prepare.
Step 2: Get into position
You’re already quite pregnant by 34 weeks, so you’ll need to find a comfortable position where you can reach your perineum. Some options are having one leg propped up, squatting, or sitting while leaning back with your knees bent and open. Different positions may be more comfortable on different days, so feel free to adjust as necessary depending on what feels good for your body.
Step 3: Prep the area
Massage oil helps alleviate some of the discomfort that can happen with this technique. Grab your perineal massage oil, or any natural oil like olive or coconut oil, or a personal lubricant; it’s your preference, as long as the ingredients are natural and suitable for perineal massage.
Rub the massage oil onto your fingers and massage it on your perineum to make sure everything is well lubricated.
Step 4: Massage away
Next, either use your thumbs or two fingers and insert them inside the vagina up to about the first knuckle, with your palm resting against your leg. Begin to stretch and massage the area side to side and up and down toward the anus. The goal is to prepare the canal for stretching, which happens on all sides during vaginal childbirth.
Step 5: Reapply and repeat
Reapply oil as needed throughout the massage, and continue these steps for up to five minutes. Please be aware that you may have slight pain or discomfort the first few times—it’s normal. Your body needs time to get used to this type of movement. Of course, stop the massage if the pain is unbearable, and contact your doctor or midwife to discuss it.
Perineal massage can be a great tool to help improve your vaginal childbirth and postpartum experience. It’s something short and simple that you can add to your preparations toward the end of your pregnancy. And just before welcoming a baby, short and simple is the name of the game.