Perineal Massage, what is it and is it actually safe?

Perineal Massage of the perineum can help reduce the risk of tearing or needing a cut while giving birth. So, let’s take a look at exactly how to do perineal massage.

As a midwife, I’ve supported many moms through giving birth. I’m always amazed at that final moment as the baby enters the world. It’s truly a miracle of mother nature that our bodies are designed to do it. However, many women spend their time in pregnancy worrying about the process, for one reason or another.

A common fear is a thought of tearing during labour or needing a cut (episiotomy) as the baby is born. Being completely honest, 85% of women giving birth vaginally will experience some sort of trauma in this area, with 60% to 70% requiring stitches after their baby has been born.

But here’s some good news: there are several things you can do to help reduce the risk of damage – and one of those is perineal massage.

So, for those of you about to close your eyes and stick your fingers in your ears, in the hope that it won’t happen to you, don’t stop reading yet!

What is the perineum?

The perineum is the area of skin and the underlying muscles that run between your vaginal opening and back passage (anus). It’s this area that stretches as the baby’s head is born.

It is also the area that tends to tear during birth, or be cut if required by the medical circumstances.

What is perineal massage?

Perineal massage is the regular massage of the perineum, both inside and out, in preparation for birth.

Once you reach 34 weeks of pregnancy, you should ideally do it two or three times each week until your due date. But you want to do it daily, that’s perfectly fine too. It only takes about five or 10 minutes.

Some people ask their partners to do it for them, as the area becomes more difficult to reach with a growing bump.

While others like to incorporate it into intimate moments, as it feels more natural to them that way.

Either way, neither of you will be asking ‘what is perineal massage’ once you’ve got used to it!

How to do perineal massage

Prepare – Make sure you (or your partner) have clean hands and short fingernails. Also, empty your bladder beforehand and take the time to relax somewhere that you won’t be disturbed. Bedtime is ideal, especially after a bath or shower, as it helps to warm the tissues around the perineum.

Get into position – You can put one foot up on the toilet lid (or a bath, or stool, or edge of the bed), or squat; or semi-sit. Some people find it useful to use a mirror to help them see the area and become more familiar with the process.

Use lubrication – As with any massage, oil helps the process go more smoothly. It’s vital to choose something that’s suitable for the sensitive area of your perineum – so we recommend our Down Below Perineal Massage Oil. Our oil is made from a carefully selected blend of natural plant oils, except nut oils. It is completely allergen-free to avoid any risk of irritation.Down Below Perineal Massage Oil has been thoroughly checked by our chemists to make sure it’s safe to use. Using the oil is also clean and hygienic, with a pipette dispenser to make sure it ends up on your fingers and not dribbling down the side of the bottle!

The actual massage

Start massaging – Put one or two drops of Down Below Perineal Massage Oil onto your fingers, then place your forefingers and middle fingers on the outside of your perineum, with your thumbs about 2 inches (5cm) into your vagina. Then:

  • Press downwards with your thumbs in the direction of your anus, so you can feel the stretch of muscles surrounding the vagina and vaginal tissues.
  • Use your thumbs to sweep from side to side in a rhythmic ‘U’ shape (or ‘hammock’ movement), while massaging from the outside with your other fingers. You should be applying steady pressure towards the anus.
  • If your partner is performing the massage, they should follow the same instructions, so ask them to use their index fingers in the same ‘U’ shape. You’ll need to tell them how much pressure feels right.
  • While this may tingle, it should not hurt. It will also help you prepare for the sensation you’ll experience when your baby’s head begins to crown during birth.

Practice makes perfect – When you first start, your perineum may feel tight. But in time, you’ll begin to feel a change as the tissues stretch and relax – and remember, it should not hurt. If it does, you should reduce pressure (and consult your midwife if it still feels wrong).

When is it safe to do perineal massage? 

Perineal massage is safe for most people, providing you follow the guidelines above.

However, do NOT do perineal massage if you have herpes, vaginal thrush or any other known infections. If you suspect you have an infection, you should talk to your midwife or GP for advice and treatment.

All midwives know about perineal massage and most will talk to you about it towards the end of your pregnancy. If you have any questions or concerns, don’t hesitate to ask them.

Want to know about other ways to reduce the risk of tearing during labour? Keep watching the Natural Birthing Company blog for more advice – and please also feel welcome to get in touch with us if you have any questions about our products.

BUY Perineal Massage Oil ‘Down Below’ in our shop!