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How to Do Perineal Massage: Best Oil & Step-By-Step Guide

Blonde woman holding crocheted vagina with an excited look on her face and text overlay that says how to do perineal massage step by step guide

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What if I told you that you could reduce your risk of vaginal tearing during delivery in 5 minutes a day during the weeks leading up to birth? It sounds too good to be true, but research has shown that it is true, indeed!

According to recent research, most vaginal births are associated with trauma to the perineum. In fact, 4 to 8 out of every 10 births result in a vaginal tear, with roughly 2/3 of women who tear requiring stitches. It doesn’t have to be this way. 

[This article has been medically reviewed by Merci Treaster, PT, DPT, and owner of The Pelvis Pro. Find her on Instagram @thepelvispro.]

The good news is that research proves that perineal massage reduces the risk of perineal trauma, as well as ongoing pain after delivery. 

So why aren’t most expecting moms doing perineal massage? For most, the answer is simple: they don’t know how to do it or about its benefits! 

We’re here to solve that problem, mama. 

We have answers to all your questions, plus a step-by-step guide, diagrams, charts, recommended oils, and even a forthcoming video to give you all the details you need about how to do perineal massage!

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What is Perineal Massage?

In women, the perineum is the section of skin located between the vaginal opening and the anus. It’s a sensitive, erogenous area, and it’s connected to muscles that play an important role in daily life. It plays an especially important role in childbirth. 

Why does the perineum tear during labor?

Vaginal tearing is common during childbirth and can occur in 4 different degrees of severity. 

According to the Mayo Clinic, “Vaginal tears during childbirth, also called perineal lacerations or tears, occur when the baby’s head is coming through the vaginal opening and is either too large for the vagina to stretch around or the head is a normal size but the vagina doesn’t stretch easily.”

Historically, an episiotomy, in which a doctor cuts the perineum to assist in labor, was used to prevent tearing. This practice has become less common as research now shows that episiotomies don’t prevent tearing or improve healing. 

How does perineal massage help prevent tearing?

The goal of perineal massage is to slowly and gently stretch the tissue around your vaginal opening so it will be more elastic when it’s time to push out your baby. 

The American Pregnancy Association says we can lessen our risk of vaginal tearing during labor and delivery by practicing perineal massage during the last 3-4 weeks of pregnancy. 

This is a sponsored article on behalf of Fairhaven Health, meaning I have been compensated for this article. All the content included is my honest opinion and has been medically reviewed for accuracy. I only work with brands and recommend products I personally use and love.

How to Do Perineal Massage

So you’re convinced it’s worth the 5 minutes a day to reduce your risk of tearing, but the logistics of how to do perineal massage seem confusing? Good news, friend! It sounds a bit intimidating, but perineal massage is actually VERY simple. 

Seriously, take 5 minutes to learn what to do. It’s worth it. We’ll give you a step-by-step guide below. 

When to Start Perineal Massage

Most practitioners recommend beginning perineal massage 3-4 weeks before baby is expected to arrive. 

Dr. Peter Rizk, MD, MA, FRCOG, FRCS, HCLD, FACOG, FACS (so many letters!) is Professor and the Head of Reproductive Endocrinology & Infertility at the University of South Alabama is a medical advisor for Fairhaven Health, who makes the best perineal massage lubricant on the market–but more on that later. 

“I encourage my patients to do perineal massage starting at 34 weeks of pregnancy.”

Peter Rizk, MD, MA, FRCOG, FRCS, HCLD, FACOG, FACS

This allows our bodies ample time to gear up for labor, even if it happens early. 

What Supplies Do I Need?

When getting ready to perform perineal massage, you’ll just need a few simple things:

Yep. That’s all! I told you this was simple, right?

Who Can Do Perineal Massage?

Perineal massage can be performed by a partner for ease of access, but that’s not actually necessary. 

I often hear moms say they’re uncomfortable asking their partners to help perform perineal massage. If this is you, no worries–you can actually do it yourself! 

We’ll give you instructions for doing it both ways: alone, or with help from a partner. 

And of course, you don’t have to do it the same way each time! You could perform perineal massage yourself some days, or have your partner help when they’re available. 

Can I Use Coconut Oil (or other household product)?

If you spend much time hanging out on pregnancy forums, you might see recommendations to use coconut oil, or even olive oil, vegetable oil, almond oil, or sexual lubricants. The claim most moms make is that there’s no reason to pay for a specific perineal massage product when you could use a household product that does the exact same thing.

What we want these moms to know is that these common household products don’t actually perform the same function, and they pose risks that a perineal massage gel does not. 

The most obvious risk is irritation, which no one wants to deal with around their vagina, especially with childbirth on the close horizon. Many of these oils contain free radicals, which increase the risk of inflammation and irritation. 

Also, using these common oils has been shown to increase the risk of vaginal infection. Clinical studies have also found that some of the recommended oils, such as almond oil, can increase the risk for preterm labor. So, let’s steer clear of that, k?

So what should you use?

We recommend BabyIt Perineal Massage Gel by Fairhaven Health. It’s the first product designed specifically for perineal massage, and it takes all of mama’s vaginal healthcare concerns into consideration. And, it’s paraben-free and free of other harsh preservatives. 

photo of perineal massage gel next to box
This perineal massage gel from Fairhaven Health is great for perineal massage!

It’s also isotonic, meaning its salt concentration matches the salt levels of the cells in your perineum. This is why it’s a better choice than sexual lubricants, which are hypertonic and can irritate or damage the perineum. 

In short, BabyIt provides the mild, balanced hydration your perineum needs and deserves. 

Breathing During Perineal Massage

Just like when you’re exercising, being careful with your breath is important during perineal massage. 

According to Merci Treaster, PT, DPT, and owner of The Pelvis Pro, it’s important to breathe deeply during perineal massage, taking full, 360-degree diaphragmatic breaths.

To practice these breaths, sit up straight and take a slow, deep breath, pulling the air deep into your diaphragm. For a 360-degree breath, you want to feel expansion in your belly, sides, and back, as you breathe in, and softening as you breathe out. 

According to Treaster, when breathing properly, your pelvic floor will naturally lengthen on inhale and shorten on exhale. Think about lengthening your pelvic floor with each inhale to help prepare your perineum for stretching. 

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Step-By-Step: How to Do Perineal Massage

Now that you’re prepped and ready, here’s what you need to do, including perineal massage diagrams to guide you easily through the process

1. Clean hands or put on sanitary gloves

So this one is an absolute no-brainer. Wash your hands, or better yet, wash your hands AND wear gloves. You don’t want any bad bacteria anywhere near your vagina. 

2. Find your preferred position

I often hear expecting moms ask, “How am I supposed to reach to do this myself?!” But I promise it’s possible! 

There are 3 positions most moms prefer for comfortably performing perineal massage by themselves. You can also ask your partner to perform the massage for you. 

Standing with 1 Leg Raised

Most moms perform this position in the shower using either a shower stool or bench. 

Stand flat on one foot while raising the opposite leg onto a higher surface. Then, reach behind your back to easily reach your perineum.  

Drawing of woman from behind. She is facing a wall with her left leg on the floor and her right leg propped on a stool. Her hands are reaching down behind her back as she performs perineal massage.
Many moms prefer this position when learning how to do perineal massage.

Gently Reclined

Most moms use this position in bed, lying at a gentle recline propped on bed pillows.

Once you are reclined comfortably, bend your knees and reach under your belly. If this is difficult for you, you can use a pelvic wand or perineal massage tool for greater ease. 

Woman lies on bed propped on pillow with her knees bent and her hands on her pregnant belly
You may already be used to this position so it would be great to use when learning how to do perineal massage.

Squatting 

Using a support underneath you for stability and safety, squat with your legs against the wall or in a high-backed chair. Please be sure you’re well supported.

Sit carefully on your sitz bones with a straight back. Carefully widen your legs, and reach around the underside of your belly to access your perineum. 

Pregnant woman sits on a stool with her back straight against a wall and her legs just wider than hip distance apart. Her arms reach below her pregnant belly to her perineuml.
Make sure that you are fully supported! Here’s how to do perineal massage in this position.

 

Reclined with Partner Support

Sit on the bed and gently recline onto propped pillows or a raised bed. Ask your partner to sit across from you. 

Once comfortably reclined, bend your knees gently. Your partner can sit across from you, facing you, and also with bent knees. This position should allow your partner comfortable access to your perineum. 

Pregnant woman sits on bed, reclined against a pillow, with her legs gently bent. A man sits across from her with his legs also bent next to her legs.
Your partner can also learn how to do perineal massage.

3. Lubricate your fingers with BabyIt Perineal Massage Gel 

photo of perineal massage gel next to box

4. Using lubricated fingers from both hands, place the forefinger or thumb (whichever is most comfortable) about 1 inch into each side of your vaginal opening. where the muscles form a tight, U-shaped rim. 

Your goal is to make this firm tissue stretchier before childbirth. By improving muscular flexibility, you’ll decrease resistance in your perineum during labor. 

female perineum with woman's thumbs inside her vaginal canal on each side

Pro Tip: Be careful not to clench your pelvic floor during perineal massage. If your core is firing, so is your pelvic floor, so breathe and relax both. Take deep, 360-degree diaphragmatic breaths as you slowly massage.

5. Slowly massage from the sides to the back of your vaginal canal, near your rectum, and then back to the sides. Repeat.

female perineum with woman's thumbs inside her vaginal canal on each side. There are arrows showing that she will massage toward her anus and then outward.

Your goal is to stretch and widen the U-shaped rim at the back of your vaginal canal. 

female perineum with woman's thumbs inside her vaginal canal on each side. There are arrows showing the u-shaped rim at the back of her perineum, which her goal is to stretch using perineal massage

6. Massage slowly for 4 to 5 minutes. 

7. Repeat daily.

Pro Tip: If you feel an overwhelming burning sensation, decrease the intensity of your massage. If you feel a slight burning sensation, you’re doing it right!

Why Is the Slight Burning Sensation Important?

The biggest pushback we hear regarding perineal massage is that it isn’t a relaxing massage in the way we generally think of massage. 

If performed properly, perineal massage is mildly uncomfortable. 

The goal of perineal massage is twofold–to improve the elasticity of your perineal muscles to easily stretch during labor, and to prepare your body for the burning sensation that will occur during the transition stage of labor. 

Not to be cliche, but mama–feel the burn! It’s a tremendously important part of this process. 

By learning to relax and breathe through the burning sensation before labor, you will decrease your risk of tensing your perineal muscles when you feel the same burning sensation during labor. And tensing those muscles while pushing the baby out increases your risk of perineal trauma. 

Perhaps that’s why, despite the burning sensation, “Over 75% of women who were taught the correct method for [perineal massage] said they planned to use it in their next pregnancy and 87% said they would encourage their friends to use the technique.” 

These statistics from a study published in the medical journal The Lancet demonstrate just how useful perineal massage can be. 

And don’t worry–the discomfort only lasts for the first week or two!

How Often to Do Perineal Massage

Now that you know how to do perineal massage, practice it daily in different positions to determine the one that is most comfortable for you. 

You’ll notice that, as the weeks’ progress, the massage becomes more and more comfortable. This is a good sign. A decrease in the burning sensation or feelings of discomfort indicates that you’re learning to relax as your perineum stretches, which is exactly the effect you want to support your perineal muscles through labor. 

Perineal Massage Q&A

How do you perform a perineal massage?

A pregnant person can perform perineal massage alone or with the assistance of a partner. Using the thumb or index finger from both hands, along with an appropriate lubricating gel, insert fingers about one inch into the rear sides of the vaginal canal (near the anus.) Slowly massage the tissue, stretching it slightly, for 4-5 minutes. 

How do I know if I am doing perineal massage correctly?

If you experience an uncomfortable burning sensation while performing perineal massage, you can feel confident you’re doing it correctly. Extremely painful burning is a sign that you’re using too much pressure, while no burning sensation indicates you aren’t effectively stretching your perineal muscles.

What position is best for perineal massage?

People performing perineal massage with a partner typically prefer sitting across from one another on a bed or flat surface, with the pregnant person at a slight recline with her knees bent. If you’re performing perineal massage on yourself, you can do it in any of 3 positions: 1. Sitting at a slight recline with knees bent; 2. Standing with one leg up on a stool or bench; 3. Squatting on a box or chair with legs separated.

How do partners do perineal massage?

Partners can perform perineal massage by sitting across from the pregnant person and inserting their clean fingers one inch into the rear sides of the vaginal canal, near the anus. Be sure to use proper lubricant. Slowly massage the perineal tissue, stretching it slightly, for 4-5 minutes. 

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Did you experience tearing after 3-4 weeks of perineal massage?

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