Step-by-Step Perineal Massage Routine for Expectant Mothers

PhysioMatters
7 hours ago
2 min read

Preparing the perineum before childbirth can make a meaningful difference in delivery outcomes. Research shows that antenatal perineal massage reduces the likelihood of needing an episiotomy and lowers postpartum perineal pain, particularly for first-time mothers (Dowswell, T., et al, 2013).

The massage works by gently stretching and increasing the elasticity of the vaginal and perineal tissues, helping them adapt more effectively during birth.

When Should You Start Perineal Massage?

Clinical guidelines recommend starting perineal massage from week 34 of pregnancy onwards, daily for 5-10 minutes (Dowswell et al., 2013).

What You’ll Need Before You Begin?

Before beginning, ensure your hands are clean and nails trimmed to prevent injury. Choose a comfortable, private space such as your bedroom or bathroom. Do remember to use a safe, non-irritating lubricant.

Getting into the Right Position

Evidence-based guides recommend semi-reclined, squatting, or side-lying positions, whichever feels most comfortable (National Childbirth Trust, 2021). Using pillows for support or a mirror for visibility of the perineum can be helpful. These positions make access easier and reduce strain during the massage.

Step-by-Step Perineal Massage Routine

Warm Up – Apply a warm compress or take a warm bath to relax tissues.
Lubricate – Apply oil or lubricant to your thumbs and perineal area.
Finger Placement – Insert your finger about 2–3 cm inside the vaginal opening.
Gentle Pressure – Press downwards and sideways toward the rectum and thighs.
Stretching Motion – Massage in a slow “U” shape for several minutes.
Breathe & Relax – Focus on steady breathing, which helps release pelvic floor tension
Build Duration – Start with 5 minutes and gradually work up to 10 minutes daily.

Tips for Safety and Comfort

Massage should never be painful. Stop if you experience sharp pain, bleeding, or discomfort. Gentle, controlled movements are key. Feel free to involve your partners as well!

When Not to Do Perineal Massage?

Avoid massage if you have active vaginal infections, unexplained bleeding, or medical restrictions. Always consult your gynecologist if you are unsure.

Additional Ways to Support Perineal Health

Perineal massage is one part of preparation. Pelvic floor muscle exercises with guidance from a Women’s Health Physiotherapist can also reduce perineal trauma and improve recovery (Aasheim et al., 2017).

Chat with our Women’s Health Physiotherapists to find out more!

Cheers

Danielle, Xan & Claire - PhysioMatters Singapore