Find out what perineal massage is and how it might work to help you avoid a tear or episiotomy when you give birth.
What is the perineum?
The perineum is the area of skin and muscle between your vagina and anus.
What can happen to the perineum?
The pressure of giving birth on your perineum means it can tear or need an episiotomy (surgical cut) when your baby is born. This is more likely if it’s your first vaginal birth.
"Four to eight in 10 women have a perineal tear and about two-thirds need some stitches afterwards (American College of Nurse-Midwives, 2016)."
An episiotomy is a non-routine surgical cut to the vaginal opening, which helps speed up delivery during a difficult labour or helps to avoid tears.
Many women experience pain, discomfort and sexual difficulties for up to three months after a perineal tear or episiotomy (Beckmann and Stock, 2013; Driscoll, 2014).
Yet there is something you can do that might help – perineal massage.
What is perineal massage?
Perineal massage is a way of helping to prepare the perineum for childbirth, making it more flexible so it can stretch more easily during labour (Beckmann and Stock, 2013). Massaging the perineum might reduce the chances of a tear or an episiotomy during labour and reduce perineal pain afterwards (Beckman and Garrett, 2006). This is particularly the case for women giving birth vaginally for the first time (Beckmann and Stock, 2013).
Perineal massage involves massaging the area between the vagina and bottom during late pregnancy. Some women massage their perineum themselves, while others prefer to get their partner to help.
When can I start doing perineal massage?
From when you’re 34 week pregnant onwards.
How do I do perineal massage?
Can perineal massage help me avoid a tear or an episiotomy?
It’s possible, although not guaranteed. A number of things can affect whether you tear or need to have an episiotomy during childbirth.
Is there anything else I can do to prevent a tear or an episiotomy?
Your midwife can help you to avoid a tear when you’re in labour. When the baby's head becomes visible, they will ask you to stop pushing and take some quick short breaths and blow out through your mouth. This helps your baby’s head emerge slowly, giving the perineum a chance to stretch gently (NHS, 2017).
It’s also a good idea to keep up your pelvic floor exercises throughout pregnancy. This helps ensure your pelvic muscles are strong and supportive during labour and after you give birth.
If you need further information about or support with perineal massage talk to your midwife or GP.
This page was last reviewed in September 2018.
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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: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005123.pub3… [Accessed 1st September 2018]
Beckmann MM, Garrett AJ. (2006) Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev. (1):CD005123. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005123.pub2… [Accessed 1st September 2018]
Driscoll A. (2014) In pregnant women, what are the effects of antenatal perineal massage for reducing perineal trauma? Cochrane Clinical Answers. Available from: https://www.cochranelibrary.com/cca/doi/10.1002/cca.293/full [Accessed 1st September 2018]
NHS. (2017) Episiotomy and perineal tears. https://www.nhs.uk/conditions/pregnancy-and-baby/episiotomy/#preventing-a-perineal-tear [Accessed 1st September 2018]
Royal College of Midwives. (2012) Care of the perineum. Available from: https://www.rcm.org.uk/sites/default/files/Care%20of%20the%20Perineum.pdf [Accessed 1st September 2018]