How To Do A Perineal Massage
What is a perineal massage?
A perineal massage is stretching the perineal tissue using one’s own fingers. The goal of a perineal massage is to prepare your vaginal tissues for childbirth through gentle perineum stretching (also commonly searched as “stretching perineum” and “how to stretch the perineum”, or even “how to stretch your vigina”).
What does a perineal massage do?
Research indicates that regular perineal massage during a first pregnancy can be beneficial. It may help reduce the need for stitches. This includes stitches from a perineal tear or an episiotomy during vaginal delivery.
When should you start perineal massage?
It is important to start a perineal massage between 30-34 weeks of pregnancy and to do it at least 3-4 times per week in order to help create flexibility and stretching in the pelvic floor tissues, and to avoid tearing during birth.
How to Massage the Perineum:
A perineal stretch can be done in multiple positions by yourself or with the help of your partner. The key is finding a position where you are comfortable and where your pelvic floor is the most relaxed.
We typically recommend these positions for perineal massage:
Sit in a semi-reclined comfortable position, with your knees bent and your legs apart.
Standing in the shower with your leg up on a ledge.
Step 1: Prolonged Stretch – Place your thumbs about 1 to 1 1/2 inches (to or just past your first knuckle) inside your vaginal opening. You can use a water based lubricant if you like.
Press down toward your rectum “6 o’ clock” and toward the sides at the same time “4-8 o’ clock”. Gently and firmly continue stretching until you feel a slight burn or tingling. Hold this stretch for about 1-2 minutes. (This is the main part of perineum stretching.)
Step 2: Gentle Massage with Thumbs – Now slowly and gently massage the lower part of the vagina “4-8 o’clock” back and forth, hooking your thumbs onto the sides of your vagina and gently pulling the tissue forward, as your baby’s head will do stretching through the birth canal. Continue massaging for 3-4 minutes. (This step is often what people mean when they search how to vaginal massage or vaginal massage, in this context, it’s still focused on the perineum and birth preparation.)
Step 3: Gentle Massage with Thumbs and Forefingers – Finally, massage the tissue between the thumb and forefinger back and forth for about 1 minute.
Total Time: 5-7 minutes, maximum 3-4 times a week
Be Gentle! A vigorous touch could cause bruising or swelling. During the massage, avoid pressure on the urethra (urinary opening or “12 o clock” ) as this can lead to irritation or infection.
Conclusion
Perineal massage during pregnancy is meant to gently support tissue flexibility and comfort for birth.
If you’re experiencing pelvic pain, pressure, irritation, or any pelvic floor concerns, you don’t have to figure it out alone. Don’t hesitate to schedule a free consultation call with one of our pelvic floor physical therapists as they can provide personalized guidance and help you feel more confident and comfortable.
FAQs
Frequently asked questions about perineal massage.
How do I know if I am doing perineal massage correctly?
Follow the steps above to learn how to massage the perineum at your own pace. If anything feels confusing, uncomfortable, or you’d simply like reassurance you’re doing it correctly, we’re here to help. Please contact us at FemFirstHealth to book an appointment.
How painful is perineal massage?
Perineal massage shouldn’t be painful, but it often feels uncomfortable at first. Most people describe a stretching, pressure, mild burning, or tingling sensation, especially when holding the stretch.
What’s considered normal:
Mild discomfort that eases as you breathe and the tissue relaxes
A “stretch” feeling that stays in the mild-to-moderate range
Slight tenderness afterward that resolves quickly
What’s not normal (pause and reassess):
Sharp, stabbing, or intense pain
Pain that lingers for hours or causes swelling/bruising
Bleeding, increasing irritation, or symptoms of infection
Significant pelvic floor muscle spasm or worsening pelvic pain
How do I give my partner a perineal massage?
To complete a perineal massage, follow the same instructions above, but you will be the one massaging your partner’s perineum, instead of herself. Make sure to communicate the whole time so they can tell you if there is any pain.
