How & When to Perform Perineal Massage to Reduce Labor Pain

A step-by-step guide to self-perineal and partner perineal massages

Co-authored by Jennifer Butt, MD

Last Updated: February 5, 2024 Fact Checked

If you're pregnant, you might be hearing a lot about the benefits of perineal massage. This technique helps to relax and soften the perineum, the area between the vagina and the rectum. Perineal massage is often done late in pregnancy to help prevent tearing of the perineum during childbirth. It might feel awkward at first, but it can have a lot of benefits. Talk to your doctor to see if this is something that might be useful for you. You can perform the massage on yourself or ask your partner to do it for you.

Things You Should Know

Place your thumbs about 1 inch (3 cm) inside your vagina. Rest your other fingers on your buttocks.
Press down towards the anus and the sides of your vaginal wall. Hold your thumbs in this position for about 1 minute.
Use a back and forth U-shaped movement to gently massage the lower half of your vagina for 2-3 minutes.
Repeat the massage for 5-10 minutes total, taking breaks when you need to.

Method 1

Method 1 of 2:

Self-Massage

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Check with your healthcare provider before you begin. While perineal massage is usually really helpful, it's always a good idea to check in with your doctor when you're trying something new. Perineal massages can cause a little pain if you use too much force or don't use enough lubricant. Don't worry though—you're not going to hurt yourself or your baby.^{[1]
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- Don't let this scare you away from trying it, though. It's a pretty simple technique to learn.
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Sit in a warm bath before starting. This may help you relax before the massage, and loosen up the muscles that surround your perineum. Plus, who doesn't love a nice warm bath? Try adding lavender-scented bath oil to soften your skin and calm your mind.^{[2]
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- You don't have to soak for long—10 minutes is enough to help you relax. But if you have time to indulge in a long soak, go for it!
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Cut your fingernails short so you don't scratch yourself. The tissues in your vagina and perineum are very delicate, so take care. Cutting your nails short will prevent tearing the skin or discomfort of the body.^{[3]
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- Filing your nails into a soft oval can also help to keep them from being a little pointy or jagged.
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Wash your hands thoroughly with soap and water. You don’t want to introduce germs into the birth canal, so be sure to properly wash your hands before you begin. Just give them a good scrub like you normally would. You don't need to do anything special.^{[4]
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- Make sure you wash them after you massage yourself, too. It will help prevent the spread of germs.
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Get in a comfortable, supported position on your bed. The best place to perform this massage is in bed, where you can be nice and comfy. Prop yourself up with pillows to support your back, and bend your knees. It's helpful to feel relaxed during the massage, so it is a good idea to find a place that allows you to get comfortable. If you prefer the couch or a big armchair, do what works for you.^{[5]
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- The massage can also be done sitting on the toilet with your legs elevated. Any position that makes you feel comfortable is the right one for you.
- You can also use a hand mirror to help you see your vagina and place your hands in the proper position.
Before you start, lubricate your thumbs and the perineum tissues with a water-soluble lubricant. A pea-sized amount is all you need. Some great options are vitamin E oil, almond oil, or olive oil. You can also use a water-soluble lubricant like Astroglide or KY Jelly.^{[6]
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Place your thumbs about 1 inch (3 cm) inside your vagina. Rest your fingers on your buttocks. Press down towards the anus and to the sides of the vaginal wall. Hold your thumbs in this position for about one minute. You will begin to feel a slight burning or stretching sensation. Try not to be nervous. This is natural and is good for you.^{[7]
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- Remember to keep breathing deeply as you hold the position. This will help you to feel at ease.
- Consciously relax your muscles if you feel tense.
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Gently massage the lower half of your vagina. Use a “U” shaped movement by going back and forth, and up and down. Try to relax your muscles while you are performing the massage. Perform this motion for 2-3 minutes.^{[8]
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- Repeat the massage for about 5-10 minutes total, taking breaks when you need to. It may take up to several weeks of this daily massage before you notice that your perineal area has more elasticity.

Method 2

Method 2 of 2:

Partner Massage

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Ask your partner for help if you feel comfortable. An ideal partner choice for this intimate situation should be someone you can relax with such as a significant other. You don't want your muscles or mind to feel tense.^{[9]
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- Be prepared for emotional reactions. Even if your trusted intimate partner is doing the massage, you may have feelings of awkwardness and modesty. This is perfectly natural. It's okay to be nervous!
- Communicate with your partner. Let your partner know if you experience any discomfort, or if you want them to stop.^{[10]
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Get in a position where you can relax your muscles and be in a position while your legs are open. Try laying on the bed with your knees bent, and use pillows to support your back. Your partner can perform the massage while you are in this position.^{[11]
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Shorter nails will help prevent the risk of scratching and clean hands will help keep any germs from spreading. Have your partner take a few extra minutes for some hand hygiene before starting. If you want, have your partner put on latex gloves to wear during the massage to keep the area sanitized.^{[12]
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Either you or your partner can put a few drops of water-soluble massage oil on your perineum. Good choices include vitamin E oil, almond oil, or olive oil. You could also use any water-soluble lubricants you have at home.^{[13]
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Begin by having your partner massage the area gently. Next, they'll rub the outside area of your perineum using their thumbs. Slow, back and forth motions on the outer area between your anus and vagina will help you both ease into the massage.^{[14]
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- Do this for 1-2 minutes, or until both of you feel comfortable moving on.
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Have your partner insert 2 index fingers inside your vagina. Instruct them to use their index fingers instead of the thumbs to do the massage. Once inside the vagina, have them massage the back wall of your vagina in a “U” shaped, side-to-side motion using downward pressure.^{[15]
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- Continue this motion for about 2-3 minutes. Let your partner know if it feels okay, or if you need more or less pressure.
- You can say, "That feels good," or "A little less pressure, please."
- Repeat the massage for 5-10 minutes total. You'll notice the elasticity of the area improve over time.
- Try to perform the massage daily in the final 6 weeks leading up to your delivery. It might make your birth easier.

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Tips

Be sure to pull gently outward, and forward, as you massage. This will help the skin stretch.

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Ask your healthcare provider for tips if you're nervous about getting started.

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