Perineal Massage Guide

Firstly, let me start off by saying that it is amazing that you’ve decided to look into perineal massage techniques.

This tells me that you are taking control of your pregnancy and you’re serious about making the experience better.

You know that you can take matters into your own hands and you are willing to put in some effort and prepare for childbirth, so well done!

In this guide, I’m going to guide you through perineal massage technqiues, and if you’d like to stick around and take a look at my hypnobirthing online guide, there is much more I can show you.

Let’s get started!

Why Perineal Massage?

When you give birth vaginally, tearing is very common.

In fact, between 40% and 80% of vaginal births can result in some degree of tearing.

This can result in problems with your pelvic floor including sexual discomfort, incontinence, or uterine prolapse.

A tear can form under the vagina and above the anus in the area known as the perineum.

This tearing can occur because this area, unlike the vagina is not very elastic. This means that as your baby delivered and your vagina stretches, the perineum gets pushed beyond its ability to stretch and the area forms a tear.

Tears can be classified as first, second, third, or fourth-degree tears.

First-degree tears involve only the perineal skin, second degree tears involve both the perineal skin and muscle, third-degree tears involve the anal sphincter and fourth-degree tears involve the anal sphincter as well as other tissues.

Now that the bad news is out of the way, I want to reassure you before you get too worried – nearly all tears are minor. Only between 0.25% and 2.5% of tears are third or fourth-degree tears.

Even so, we should still do everything in our control to stack the odds in our favor right?

Thats where perineal massage comes in!

It is thought that by massaging the perineum, from week 32 of pregnancy, we can make the area more supple and elastic, allowing it to stretch more during vaginal birth and reduce tearing. Most experts recommend carrying out a perineal massage 2 or 3 times a week.

Doing perineal massages as part of your preparation can also help you recover faster after giving birth – something we all want!

This is because it can help to reduce bruising as well as tearing and can reduce the chance of an episiotomy being required (when a small incision is made to make the opening of the vagina wider).

OK, so now we know why we need to do a perineal massage. Now let’s take a look at how to actually do it right.

How To Do a Perineal Massage

Let’s get straight to the point so you can learn quickly how to o a perineal massage the right way. Remember that this is something you would do from week 32 of pregnancy.

Find some time when you won’t be disturbed and you’re nice and relaxed. After a warm shower or bath is a good time as your blood vessels will be dilated so your perineum will be softer and more comfortable to touch.
Make sure your bladder and bowels are not full and wash your hands before you begin.
Choose some lubricant if you prefer. Choose a water-soluble jelly, almond oil, coconut oil, sunflower oil or vitamin E oil. Avoid scented oil, mineral oil, baby oil or petroleum jelly.
Recline on a bed or sit in a comfy chair.
Insert your thumb 3 to 5 cm inside your vagina.
Push down gently towards your anus until you feel a stretch. Start off doing this for a few seconds to see how it feels. If it feels fine, then you can build up to holding the stretch for up to 1 minute.
In a ‘U Shape’ motion, move your thumbs to apply pressure to each side of the vagina. Again, hold the stretch in each direction for up to 1 minute.

OK, so now you have a step by step guide to follow, but to help explain the technique, even more, I’d recommend you watch this handy video from Midwife Marley.


So now you know that perineal massage can be very useful and you know everything you need to get started.

I’d recommend starting with the perineal massage technique from 32 weeks of pregnancy. Once you start, try to establish a habit of doing them regularly and aim to do them 3 times a week on nonconsecutive days, for example, Monday, Wednesday, and Friday.