What Is Perineal Massage (and Should I Do It?)
A Calm, Evidence-Informed Guide to Preparing for a Smoother Birth
You may have come across the term perineal massage in a birth prep class or pregnancy book and wondered what it’s all about. Does it actually help? Is it awkward? Is it even necessary?
At Neutral Nest, we believe in calm, confident preparation — not pressure. So here’s what perineal massage is, when and how to do it, and why many birthing parents give it a go in the final weeks of pregnancy.
What Is Perineal Massage?
Perineal massage is the practice of gently stretching and massaging the perineum — the area between the vagina and the anus — in the weeks leading up to birth.
It’s usually done with a natural oil or lubricant and is intended to:
Help prepare the tissues for stretching during childbirth
Reduce the risk of perineal tearing or the need for an episiotomy
Make the sensation of crowning feel more familiar
Help you feel more confident and in tune with your body
It’s a short, simple ritual that some people find empowering — and others choose to skip. Either way, you are not doing pregnancy wrong.
Does It Really Work?
Research suggests that perineal massage may reduce the chance of tearing — particularly for first-time vaginal births.
Specifically:
It may lower the risk of needing stitches or an episiotomy
It may reduce the severity of tears if they do happen
It can help increase blood flow and elasticity in the area
Like many birth preparation tools, it’s not a guarantee — but it can be a gentle, proactive way to support your body.
When Should I Start?
You can begin perineal massage from around 34–35 weeks pregnant, doing it 3–4 times a week, or as often as feels right for you.
If you’ve had any complications or concerns (such as placenta previa, vaginal infections, or early labour signs), always check with your midwife or GP before starting.
How to Do Perineal Massage — Step by Step
You’ll need:
Clean hands
A safe, natural oil (like vitamin E, almond oil, or organic perineal massage oil)
A quiet moment — after a bath or shower is ideal
1. Get comfortable:
Find a relaxed position — lying down propped on pillows, sitting in a warm bath, or standing with one foot raised on the edge of the bath.
2. Apply oil:
Rub a small amount of oil onto your thumbs (or fingers, or partner’s thumbs if they’re helping) and onto the perineal area.
3. Massage gently:
Insert both thumbs about 2–3 cm into the vagina.
Press downward (toward the anus) and to the sides, in a U-shaped motion.
Hold gentle pressure for about 30–60 seconds, then repeat with slow movements for 5–10 minutes.
4. Tune in:
You may feel stretching or tingling, but it shouldn’t be painful. Breathe slowly and focus on relaxing your pelvic floor.
Tips for a More Comfortable Experience
Do it after a warm bath to relax the muscles
Use plenty of oil to reduce friction
Try deep belly breaths to stay calm
If it feels too awkward solo, ask a trusted partner to help
Stop if it ever feels painful, and check with your care provider
Is It Right for Everyone?
Not necessarily — and that’s okay.
You might not want to do perineal massage if:
You have a vaginal infection
You’re at risk of preterm labour
You feel triggered, tense, or uncomfortable doing it
Remember: perineal massage is optional. It’s one tool among many — and it’s not the only way to protect your perineum or support a positive birth.
Final Thoughts
Perineal massage is a small, intentional practice that helps many parents feel more connected to their body and better prepared for birth.
Whether you try it once or make it part of your weekly routine, the most important thing is that you feel supported, informed, and in control of your choices.
At Neutral Nest, we’re here to help you prepare for birth with calm and clarity — no pressure, just gentle support for whatever feels right in your body.