Perineal massage

Perineal massage is a simple technique you can do in late pregnancy to help prepare the perineum (the area between the vagina and anus) to stretch during birth. There’s reasonable evidence it can reduce the chance of tearing or needing an episiotomy, particularly for first-time mums — and it’s free, safe and something you can do yourself.

What it’s for. During a vaginal birth, the perineum stretches a lot, and some tearing is common. Gently massaging and stretching the area in the weeks before birth can improve its flexibility and help you get used to the sensation of stretching, which may reduce the risk or severity of tears. It won’t guarantee no tearing, but it can help.

When to start. It’s generally recommended from around 34–35 weeks onwards, done a few times a week (many suggest once daily or a few times weekly). There’s no benefit doing it earlier in pregnancy, so late third trimester is the window.

How to do it. Get comfortable and clean (wash your hands, empty your bladder). A warm bath or shower first helps relax the tissue.

• Use a natural oil (like a plain vegetable or almond oil, or a product made for the purpose) on your thumbs or fingers.
• Insert your thumbs (or one thumb) a few centimetres inside the vagina, pressing gently downward (toward the anus) and out to the sides, until you feel a mild stretch or tingling — not pain.
• Hold the stretch for a minute or two, and gently massage the lower part of the vaginal wall and perineum for a few minutes.
• A partner can do it for you if that’s easier (using fingers rather than thumbs). Some people find it easier to use a mirror at first.

Make it comfortable. It can feel a bit odd or intense to start with, but it shouldn’t hurt. Relax, breathe, and ease off if it’s painful. As the weeks go on and the tissue softens, it usually gets easier and you may be able to stretch a little further.

When not to, or to check first. Don’t do perineal massage if you have vaginal infection, thrush, herpes, or a condition like placenta praevia or a history of certain complications — check with your midwife first if you’re unsure whether it’s suitable for you. Stop and ask if you have pain, bleeding or any concerns.

It’s optional. Perineal massage isn’t essential, and plenty of people don’t do it and are fine — tearing also depends on lots of factors on the day (baby’s size and position, how the birth unfolds, birthing position). Think of it as one helpful, low-effort thing you can do, not a must-do or a guarantee.

If you’d like to try it, ask your midwife to talk you through the technique — many are happy to. Start from around 34 weeks, keep it gentle and regular, and combine it with the other things that help (like upright birthing positions and a warm compress during birth, which your midwife can support). It’s a small, self-directed way to help your body get ready.