A Step By Step Guide For Perineal Massage

Expecting a baby? Here is a step by step guide for perineal massage.

But first, what are the benefits?

Over the past few years, perineal massage has become more accepted in the birthing community, due to more and more research being released on the topic.

-It’s an easy technique and is supported by substantial research.

-By practicing perineal massage, you can reduce the risk of perineal trauma and improve perineal recovery. (As pelvic floor physiotherapists, we’re all for this!)

Why do we do it?

The goal of perineal massage is to increase tissue elasticity (stretch) in order to reduce tearing during vaginal birth. We know that the rates of perineal tearing among first time moms in Canada is very high. About 80% of first time Mom’s experience some form of perineal tearing.

What does the research say?

A 2013 review by Beckman & Stock (2013) concluded that digital perineal massage reduces the likelihood of perineal trauma (mainly episiotomies) and ongoing perineal pain postpartum and is generally well accepted by women. As such, women should be made aware of the likely benefit of perineal massage and provided with information on how to massage.

But you’re probably asking yourself….

How do I even start?

How do I do it?

How often should I do it?

Working in women’s health physiotherapy we realize that many expecting moms are not told about this valuable and important technique and every day we see their confused faces when we mention perineal massage- so here it is!

So How do I do it? Here is your step by step guide to perineal massage. 

  1. Get comfortable. Lay in a semi-reclined position in your bed with your knees bent. Make sure you relax! Being as relaxed as possible is essential.
  2. Use clean hands, with trimmed, short fingernails and a good water-based or silicone-based lubricantClick the links to check out some of our faves.
  3. Picture your vaginal opening being a clock face. The bottom of the vagina is 6 o’clock and the top is 12 o’clock.
  4. Using your pointer finger or thumb (most patients prefer their thumb) take a nice deep breath, relax and insert the tip of your finger/thumb in the vaginal opening to the first knuckle.
  5. Starting at 6 o’clock take a nice big breath and as you relax apply a stretch downward toward the number 6.
  6. The stretch should be strong, stingy maybe, and slightly uncomfortable but not painful. We want to ensure we are actually stretching the pelvic floor and perineum.
  7. Hold for ~ 30 seconds.
  8. Move to number to 7 on your clock face. Repeat the stretch at each number of the clockface until you’ve worked your way around.
  9. As you move up to around 9 o’clock it is sometimes easier to switch to your finger v.s. the thumb
  10. Start with 3 minutes and work up to 5 minutes. Practice 3-5x/a week.
  11. As you practice this it should get noticeably easier to do the stretching.
  12. As it gets easier, increase your pressure, or add stretch in two directions using both thumbs/finger.

As always, although we are physiotherapists, we are not YOUR physiotherapist. Perineal massage is not advised in some cases. Make sure you check with your physician or healthcare provider before starting at around 30 weeks.

There you have it! Your DIY playbook for perineal massage.

Hope this helps!

Katie Kelly, PT & Eryn Matheson, PT

Before you go, make sure you click here so you can get instant access to our Pregnancy, Core and Pelvic Floor FREE masterclass! In this free 60 minute masterclass, presented by Eryn Matheson, PT, you’ll get the advice you actually need to have a strong and confident pregnancy, birth and postpartum period.

And below are the many other resources we have available to help you during both pregnancy and postpartum. 

Join Reconnect+ here for on-demand education and fitness that drive real results – with your core & pelvic floor in mind. Get 7 days FREE!

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Local to New Brunswick? Book your in-person (Moncton and Fredericton NB) or virtual appointments:

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Reference. Beckmann, M. & Stock, O. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev. 2013; (4): CD005123. Published online 2013 Apr 30. doi: 10.1002/14651858.CD005123.pub3


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