Perineal massage is a simple, manual technique performed by pregnant individuals or their partners during the final weeks of pregnancy. It involves gently stretching the tissues of the perineum, the muscular area located between the vaginal opening and the anus. The practice is intended as preparation for vaginal birth, aiming to increase the flexibility and suppleness of this region. Although many search for this technique to stimulate labor, the medical purpose of the massage is not related to initiating contractions. This stretching focuses entirely on tissue readiness for delivery, not hormonal or uterine action.
Addressing Labor Induction
Perineal massage does not induce labor. It is a localized physical therapy focusing on the soft tissues of the pelvic floor and the skin of the perineum. This stretching is distinct from the physiological processes that trigger labor, which involve complex hormonal signals like oxytocin release and cervical ripening. Preparation of the birth canal tissues does not stimulate the powerful muscular contractions of the uterus required for labor to begin. The purpose is purely to help the area stretch more easily when the baby descends.
The True Goal of Perineal Massage
The primary, evidence-based goal of performing this massage is to reduce the likelihood and severity of perineal trauma during a vaginal delivery. Regularly stretching the tissues increases their elasticity and pliability for the significant expansion needed as the baby is born. This is particularly beneficial for individuals preparing for their first vaginal delivery, as their tissues have not previously experienced this degree of stretching. Studies show that regular antenatal perineal massage can lead to a reduction in the need for an episiotomy, a surgical incision sometimes made to enlarge the vaginal opening.
The technique is also associated with a decreased risk of severe perineal trauma, specifically third- and fourth-degree tears, which extend into the anal sphincter or rectal lining. For first-time mothers, the practice can reduce the overall risk of needing stitches for any tear. The Royal College of Obstetricians and Gynaecologists (RCOG) includes antenatal perineal massage as a method to reduce the risk of sustaining a serious perineal injury. Becoming familiar with the stretching and pressure sensations during the massage can also mentally prepare the individual for the feeling of the baby crowning.
Technique and Timing
Most experts recommend starting the perineal massage routine around the 34th to 36th week of pregnancy. The massage should be performed for about five to ten minutes per session, three to four times per week, or even daily, leading up to the birth. Consistency helps achieve the desired softening and stretching effect on the tissue.
Before beginning, ensure hands are clean and fingernails are trimmed to prevent injury to the delicate tissues. A natural, pure oil should be used for lubrication, such as sweet almond, coconut, or olive oil. Avoid petroleum-based products or synthetic, scented oils that may cause irritation. The massage can be performed by the pregnant person or by a partner.
To perform the massage, find a comfortable, reclined position, such as sitting semi-upright in bed with pillows for support. Insert the thumbs or fingers approximately one to two inches into the vagina. Gentle, firm pressure is then applied downward toward the rectum and outward toward the sides, following a “U” shape. The stretch should be held for up to two minutes at a time, and the entire area should be massaged using slow, continuous motions for the full session duration. It is normal to feel a slight tingling, stinging, or burning sensation, but the massage should never be painful.