perineal massage

So you know perineal massage might help you to avoid perineal tears and you’re keen to try it out. Read on for our guide to how to massage your perineum.

Research shows perineal massage in the third trimester might reduce your chances of perineal trauma if it’s your first vaginal birth (Beckmann and Stock, 2013). What’s more, most mums-to-be who tried perineal massage felt comfortable and positive about their experience. They said they’d do it again in another pregnancy and would recommend it to others (Labrecque et al, 2001).

You can massage your perineum by yourself, or with your partner if you’d prefer.

"Perineal massage aims to stretch, usually using two fingers, the perineal tissues ready for birth."

You can start practising perineal massage from 34 weeks of pregnancy onwards or for the last four to six weeks of it. Here’s what you’ll need:

  • Privacy and some uninterrupted time at home.
  • Clean hands
  • Short nails.
  • Unscented oils – vitamin E oil, coconut oil, olive, sunflower or grape seed oil, unscented personal lubricant, or perineal massage oil (which can be expensive). Don’t use synthetic oils such as baby oil or petroleum jelly (Vaseline).
  • Some pillows might be handy for your comfort – if you’d prefer to sit or lie back.
  • A mirror so you can see what you’re doing if you’re going to massage yourself.

(American College of Nurse-Midwives, 2016; Oxford University NHS Trust, 2017)

1. Be prepared

  • Wash your hands thoroughly and make sure your or your partner’s (if they’re helping) fingernails are short.
  • Find somewhere you can relax, uninterrupted and in privacy with your legs open wide and your knees bent.
  • Make sure you have your chosen oil and your mirror handy if you need it.

(Oxford University NHS Trust, 2017)

2. Find a comfy position for you

You could try:

  • being propped up with pillows on a bed or sofa so you or your partner can reach your perineum more easily
  • reclining in the bath with one leg up on the side at a time
  • standing in a warm shower with one leg up on a stool before you change legs
  • sitting on the toilet.

(Oxford University NHS Trust, 2017)

3. Lubricate your perineum

Put some oil on your perineum and the lower part of your vaginal opening. This helps to make the massage more comfortable.

4. Relax and start the massage

Taking some deep breaths might help you relax.

  1. Put your thumbs about 2.5cm to 4cm just inside the back wall of your vagina. You might find it easier to use a mirror the first few times.
  2. Press down towards your anus and to the sides. You should feel a bit of a burning, stretching feeling.
  3. Hold this stretch for about one to two minutes.
  4. Then gently massage the lower bit of your vagina for a maximum of two to three minutes, focusing on relaxing your perineum. Massage using your thumbs upwards and outwards then back again in a U-shaped movement. You could practice your slow, deep breathing techniques while you do this.  (American College of Nurse-Midwives, 2016; Oxford University NHS Trust, 2017)

Perineal massage shouldn’t hurt, though you may feel pressure in the first few weeks of starting, which should ease. Avoid perineal massage if you have vaginal herpes, thrush or a vaginal infection (Oxford University NHS Trust, 2017).

5. Partner involvement

  • It can be difficult to massage your perineum by yourself in the later stages of pregnancy.
  • You might want to start off doing the perineal massage yourself. Then as you get nearer to the due date, if you feel comfortable doing so you could ask your partner to do it.
  • Simply follow the same method as before. The only difference is that your partner should use their index fingers rather than thumbs to perform side-to-side and U-shaped downward pressure.

(American College of Nurse-Midwives, 2016; Oxford University NHS Trust, 2017)

6. Keep up the routine

  • Try to do this one to two times per week. Doing it more often won’t help more and might hurt the skin.
  • Fit it into your weekly routine, for example during or after a bath or shower. This is a good time because blood vessels in the area are already dilated, making the perineum softer and more comfortable to massage. You will also be more relaxed.

(American College of Nurse-Midwives 2016; Oxford University NHS Trust, 2017)

7. Support is available

Perineal massage shouldn’t be painful although there might be some discomfort to begin with. If you’re concerned about any pain, or you need further information or support with perineal massage, talk to your midwife or GP.

This page was last reviewed in September 2018.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about having a baby, labour and life with a new child.

American College of Nurse-Midwives. (2016) Perineal massage in pregnancy. J Midwifery Womens Health. 61(1):143-144. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/jmwh.12427 [Accessed 1st September 2018]

Beckmann M,  Stock O. (2013) Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev. (4):CD005123. Available from: http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD005123.pub3/abstract;jsessionid=CF32264FB13246A8540B877017B34E8C.f02t04 [Accessed 1st September 2018]

Labrecque M, Eason E, Marcoux S. (2001) Women's views on the practice of prenatal perineal massage. BJOG. 108(5):499-504. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/j.1471-0528.2001.00111.x [Accessed 1st September 2018]

Oxford University Hospitals NHS Trust (2017) Antenatal perineal massage. Available from:

https://www.ouh.nhs.uk/patient-guide/leaflets/files/10938Pmassage.pdf [Accessed 1st September 2018]

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