Perineal massage is the gentle, manual stretching of the tissues located between the vaginal opening and the anus, an area known as the perineum. This practice aims to increase the flexibility and elasticity of the perineum in preparation for a vaginal delivery. By softening this area, the massage may help reduce the risk of a severe tear or the need for an episiotomy during childbirth, especially for individuals having their first baby.
Essential Preparation for Self-Massage
Individuals typically begin this practice around the 34th week of pregnancy, continuing until the baby is born. Before starting, wash hands thoroughly and trim fingernails short to prevent any accidental nicks or the introduction of bacteria. The massage requires lubrication, and safe, unscented oils, such as grapeseed, sweet almond, or olive oil, are commonly used because they are food-grade and gentle on sensitive tissues.
The self-massage can be physically awkward due to the growing abdomen. Many people find it easiest to sit semi-reclined in bed with knees bent and legs apart, or to stand with one foot elevated on a stool or the edge of a bathtub. Using a mirror for the first few sessions can be helpful to visualize the perineum and confirm the correct location. Performing the massage after a warm bath or shower helps, as the heat can soften the tissues and promote relaxation.
Step-by-Step Self-Massage Technique
Once positioned, apply a small amount of your chosen oil to your thumbs and the perineal area to ensure a smooth, friction-free movement. Gently insert one or both thumbs about one to one-and-a-half inches (or up to the first knuckle) into the vagina, resting them against the lower, back wall.
The massage involves applying gentle, steady pressure downward toward the rectum and then sweeping sideways along the lower vaginal wall. Imagine the vaginal opening as a clock face, and you are working the area between the 3 o’clock and 9 o’clock positions, moving pressure toward the 6 o’clock position. The pressure should be enough to create a stretching, tingling, or mild burning sensation.
Maintain this stretch for about 60 seconds, and then gently release the pressure. Use a rhythmic, sweeping motion to massage the tissue in a “U” shape—downward and then out to the sides. This U-shaped motion should be repeated for a total of approximately five to ten minutes per session. Throughout the process, consciously focus on relaxing the pelvic floor muscles, especially when the stretching sensation is felt, as this familiarization can be beneficial during labor.
Important Considerations and Contraindications
The recommended frequency for perineal massage is about three to four times per week. Consistency is more important than excessive duration, and each session should last about five to ten minutes. The massage should never cause sharp or significant pain; only a stretching or slight burning sensation is expected, and the practice should be discontinued if pain occurs.
There are certain conditions where perineal massage should be avoided to prevent complications or the spread of infection. Do not perform the massage if there is any unexplained vaginal bleeding or if you have an active vaginal infection, such as a yeast infection, herpes outbreak, or a urinary tract infection. Individuals with specific pregnancy complications, such as placenta previa or symptoms of preterm labor, should consult with a healthcare provider before beginning the practice.