How to do Perineal Massage: During Pregnancy, Labor and Child Birth

Perineal massage means gently stretching the perineal tissue, the area between the vagina and anus, with one or two fingers. It helps prepare the area for stretching during vaginal birth. You can use your fingers and apply oil to make it more comfortable. Here’s a step by step guide to how to do perineal massage.

Perineal massage reduces the risk of tearing and episiotomy (surgical cuts), improving your chances of giving birth vaginally without causing harm to your perineum.

Perineum is the area between the vagina and the anus. It links to the muscles that support your reproductive organs, intestines, and bladder.

The perineum is usually 2-5 cm long and stretches during childbirth to help the baby come out.

Perineal massage involves gently stretching and massaging the perineal tissue with one or two fingers. It helps prepare the area to stretch during vaginal or normal delivery.

This makes the skin become more flexible, making it easier for your baby to pass through during delivery. You can do this massage on your own at home or with your partner’s help.

The gentle massage promotes elasticity and flexibility in the perineal tissues, supporting their natural relaxation and expansion during delivery.

In addition, the stretching sensation of a perineal massage offers a chance to practice breathing, making women feel more at ease and secure during birth.

Perineal massage can feel a little unfamiliar at first, but with the right preparation, it can be a simple and soothing part of your routine. Here’s how to get started:

• When to Begin: Try starting around week 35 of pregnancy; this gives your body time to adjust before birth.
• Find Your Comfort Zone: Pick a position that feels best for you: lying down, in a warm shower, or propped up with pillows for support.
• Clean Hands Are a Must: Wash your hands thoroughly before starting to keep everything fresh and hygienic.
• Use the Right Oil: A little natural oil like vitamin E, almond, or olive oil can make the massage smoother and more comfortable.
• Warm Up First: A warm bath or shower can help soften the area and make the massage easier.

• Soak in a Warm Bath – A warm bath before starting can help you relax and soften the muscles around your perineum.
• Keep Your Nails Short – The skin around your vagina is delicate. Trim your nails to avoid any scratches or discomfort.
• Find a Cozy Spot – Make sure you're comfortable before you start. Lying in bed with pillows supporting your back and slightly bending your knees is a great position.
• Use a Gentle Oil – Apply a natural oil like almond or olive oil to keep the area soft and make the massage easier.
• Place Your Thumbs Correctly – Apply oil to your thumbs and gently place them inside the entrance. Press down and slightly outward toward the perineum in a U-shape. Hold for about a minute.
• Massage in a U-Shape – Gently press down and massage back and forth along the sides of your vagina for about 3 minutes.
• Be Consistent – Doing this daily or as often as possible can help improve flexibility over time.

Step 1: Be Prepared

Before you begin, make sure your hands are clean, your fingernails are trimmed, and your bladder is empty. Bend your knees and relax in a quiet area. Use cushions or pillows for support.

Step 2: Find a Comfortable Position

Sit on the toilet, stand in a warm shower with one leg raised, lie back in the bathtub, or relax on a bed with pillows.

Step 3: Start the Massage

• Apply oil to the vaginal opening and perineum.
• Insert one or two fingers 3–4 cm inside the vagina.
• Press downward toward the anus and outward gently.
• Hold the stretch for 45–60 seconds while breathing slowly.
• Massage in a U-shaped pattern for 5–10 minutes.

Step 4: Stick to Your Routine

Practice daily or as often as possible, ideally after a bath or shower when tissues are softer and relaxed.

Using a perineal massage tool can help gently stretch the pelvic floor, improve flexibility, and reduce the risk of tearing during childbirth.

Studies show that starting perineal massage from 34 weeks helps reduce tearing and the need for episiotomy. It prepares the perineum safely for childbirth.

Around 40–80% of women experience some degree of tearing during vaginal delivery. Perineal massage improves elasticity, reducing tearing and promoting faster recovery.

Start massaging every one to two days from week 34, increasing to daily sessions of up to five minutes with your doctor’s approval.

• Reduces the risk of tearing and episiotomy.
• Decreases pain, bleeding, and need for stitches.
• Improves recovery after childbirth.
• Helps reduce long-term perineal pain.
• May reduce urine leakage postpartum.

Partners can assist using index fingers instead of thumbs. Communication is important to avoid discomfort or pain.

• Low-lying placenta.
• Vaginal infections or open wounds.
• High blood pressure during pregnancy.
• Previous perineal surgery (consult your doctor first).

Perineal massage is a simple, effective way to prepare your body for childbirth. If you have concerns, consult our best gynecologist for expert guidance.