Perineal massage is a technique that can help prepare the perineum, the area between the vagina and anus, for childbirth. This practice involves gently stretching and massaging the perineal tissues to increase their flexibility and reduce the likelihood of tearing or the need for an episiotomy, a cut made to the perineum to widen the vaginal opening, during delivery. You can commence Perineal Massage from Week 35 of your pregnancy. In this article, we will provide a step-by-step guide on how to perform perineal massage.

Step 1: Preparation

Before you begin, ensure that your hands are clean and your nails are trimmed. Empty your bladder and find a comfortable position, such as sitting with your back supported and legs slightly apart. You may want to use a mirror or have a partner assist you during the process.


Step 2: Lubrication

To reduce friction and enhance comfort, apply either a water-based lubricant, a specially formulated perineal oil or any natural oil such as olive or coconut oil, to your thumbs and the perineal area. We recommend Hymn to Her Peri Oil, which contains geranium essential oil and evening primrose oil to enhance elasticity.


Step 3: Positioning

Place your thumbs at the entrance of the vagina, with your fingers resting on the buttocks. Gently press downward and sideways, applying gentle pressure.


Step 4: Massage Technique

Using your thumbs, slowly and gently massage the perineal tissues in a U-shaped motion. Start with downward strokes, applying slight pressure towards the anus. Gradually move upward, maintaining a comfortable level of pressure. This movement should feel like stretching, rather than pain or discomfort.

Step 5: Internal Massage (optional)

If you feel comfortable and have reached a stage where you can insert your thumbs into the vagina, you can proceed with internal massage. Gently insert your thumbs about an inch into the vagina, pressing towards the rectum. Apply gentle pressure and move your thumbs in a sweeping motion from side to side. Remember to communicate and listen to your body’s signals to ensure you’re not causing any discomfort.

Step 6: Duration and Frequency

It is recommended that you perform around 3-5 minutes of perineal massage per session. Aim for a frequency of 1-2 times per week, but remember not to overdo it. Increased frequency has been shown to decrease effectiveness and is not recommended. If you experience any pain or discomfort, it’s essential to stop and consult with your healthcare provider.

Step 7: Practice Relaxation

During the massage, focus on breathing deeply and relaxing your body. Tension can hinder the effectiveness of the massage, so make an effort to release any stress or anxiety you may be feeling.


8. When to not perform Perineal Massage.

Perineal massage should not be attempted prior to 35 weeks gestation.

You should not massage your perineum if you have Placenta Praevia (a low-lying placenta) or any other condition where there is bleeding from the vagina during the second half of pregnancy. You should also not massage your perineum if you are suffering from vaginal herpes, thrush or any other vaginal infection, as massage could spread the infection and worsen the condition.


Perineal massage is a valuable technique that can help prepare your perineum for childbirth and reduce the likelihood of tearing or the need for an episiotomy. Remember that each woman’s body is different, and it’s essential to listen to your body’s signals throughout the process. If you have any concerns or questions, consult with your healthcare provider, who can provide personalised advice based on your specific needs.

Have any questions or want to share any tips? Drop us a comment below.

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