The benefits of perineal massage during pregnancy - Ruth Health

The benefits of perineal massage during pregnancy

Fast facts

  • Perineal tears during a vaginal delivery often contribute to postpartum pelvic floor issues.
  • About 40-80% of birthing people who deliver vaginally have a tear in the perineum, with two-thirds requiring stitches.
  • Regular perineal massage during the final weeks of pregnancy lowers the risk of tearing during childbirth, as well as the severity of any tears that do occur.
  • This practice consists of mobilizing the perineal tissue with your fingers to increase flexibility.
  • Always get clearance from a health professional before making perineal massage a part of your routine. Check with your provider around the 34th week about when to start.

Many individuals experience some degree of pelvic floor dysfunction after giving birth, with bladder and bowel control a common challenge.

While these postpartum pelvic health issues aren’t always avoidable, there are steps you can take to maintain a healthy pelvic floor, including perineal massage.

Below, we explain why the practice of perineal massage is an important component of childbirth prep during the final weeks of pregnancy. (Yes, one more thing to add to your third trimester to-do list, but we promise it’s worth it!)

What is the perineum?

The perineum is a portion of the pelvic region located between the vagina and anus. It also covers part of the birth canal.

The tissues in this area contribute to the overall condition of your pelvic floor, supporting your posture and preventing urinary and fecal incontinence, among other functions.

Perineal tissue should be strong yet flexible enough to prevent tearing during labor and delivery as your baby descends in the birth canal. That’s where perineal massage comes in.

The benefits of perineal massage during pregnancy

Perineal tears are one of many factors in postpartum pelvic floor issues, particularly urinary and fecal incontinence.

Tearing is common — about 40-80% of birthing people who deliver vaginally have a tear in the perineum, with two-thirds requiring stitches.

Regular perineal massage during the final weeks of pregnancy lowers the risk of tearing during childbirth. Additionally, it can lower the severity of any tearing that does occur and reduce the risk of episiotomy.

The technique consists of stretching the perineal tissue with your fingers so that it can more easily stretch over your baby during labor and delivery. You can massage your perineal tissue on your own or have your partner help.

Here’s a step-by-step overview of how to perform perineal massage.

Step one

Wash your hands with a mild soap and trim your fingernails, if needed, for maximum comfort during your massage.

Step two

Find a private, quiet space and a comfortable position from which your hands can easily reach your perineal tissue.

Common positions for a perineal massage include:

  • Sitting or lying on your bed or a couch with your knees bent
  • Sitting against a wall — use a stool, thick pillow or even a stack of books for support
  • Raising one leg in the shower

Experiment with different positions to find what’s most comfortable for you.

Step three

Apply oil or lubricant to your fingers. This will help minimize friction as well as hydrate the perineal tissue.

Since vaginal tissues are highly absorbent, it is not recommended to use products with additives, chemicals, scents, dyes, or glitter, or any with a warming, cooling, or tingling effect. Aloe-based lubricant is typically a good option.

Step four

Begin the massage using your thumbs or fingers to apply pressure at the vaginal opening. This encourages blood flow, which is necessary to manually manipulate the tissues. A warm compress can also help.

Step five

Place your thumbs or fingers about an inch inside of your vagina. You can use one or both thumbs, your index or middle fingers, or two fingers. Do what feels best for you.

Step six

Press your thumb(s) or finger(s) along the back portion of your vagina toward your anus and side to side. It’s important to apply enough pressure. While this shouldn’t feel painful, you might experience a slight burning or stretching sensation at first.

Step seven

Apply pressure with your thumb(s) or finger(s) in a stretched position for 10 seconds. Release for 2-3 seconds before applying pressure again.

Repeat this pattern for 1-2 minutes.  Then, sweep your thumb(s) or finger(s) from the center of the vaginal canal out to the sides and then back, in a U-shaped motion.

Step eight

Continue for up to five minutes.

Some people experience initial discomfort when massaging their perineum, but it will become easier and more comfortable with time.

To have your partner perform perineal massage, have them sit facing you with their legs crossed. Drape your legs over theirs for support and comfort. They should use only their index fingers during the massage.

Follow the same steps. Begin with applying pressure, gently stretching and releasing the tissue, and then creating a soft hook with the two index fingers.

Use the hook shape to gently massage downward and outward from center, slowly sweeping back and forth.

We’re here to support your birthing journey

At Ruth Health, we understand that nobody knows what you need better than you. We provide expert, evidence-based maternal advice so that you can make the best decisions for yourself.

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