What's A Perineal Massage? Time To Stretch Your Pregnancy Comfort Zone (& Other Things)

From the minute you find out you’re pregnant, everyone starts throwing (usually unsolicited) advice at you about how to best prepare your body for the arrival of your little bundle of joy and poop. And one of the annoying things about pregnancy is that it’s constantly changing, so you can’t just tell people after your first trimester that you’re all set for advice and can take it from there — inevitably, they will follow up with, “Oh, but you have no idea what’s in store for you in the second trimester.” Spoiler alert: It keeps going that way until your baby goes away to college.

Granted, whether you heed a lot of the advice comes down to personal preference and all pregnant bodies being different. But if someone wants to offer up some info on perineal massage for pregnancy, it’s time to pay attention. Here’s what to know about perineal massage, including how to do it, and the best kinds of oils to use.

What’s going on with the perineum during childbirth?

Let’s talk about the perineum. If you weren’t familiar with the area (don’t worry, you will be), it’s the region between either the vagina and the anus, or the scrotum and the anus. So unlike a lot of the parts down there, this one’s standard issue for everyone. Regardless of the genitals opposite the anus, the perineum is there to support the pelvic floor, meaning that it’s at least partially responsible for keeping your reproductive organs, bowels, and bladder held in place.

Most of the time, your perineum doesn’t see a lot of action, unless it’s from a penis or finger that has lost its way. But during childbirth, all bets are off. If you’re having a vaginal delivery, there’s a decent chance that your perineum will not emerge intact. Though the perineum tries its best to stretch to accommodate the baby’s head, it’s not always successful, and can end up tearing. But not all tears are equal: Some only involve the skin around the vagina, while others reach the anal sphincter (which are third- and fourth-degree tears). And this brings us to the episiotomy, which is a procedure where the perineum is cut in order to make room for the baby to make its debut through the birth canal. (Though they were once pretty common, far fewer episiotomies are done today.)

If any of this sounds unpleasant, it’s because it definitely is. In order to help make a vaginal delivery go more smoothly, some doctors, nurses, midwives, and doulas may recommend doing perineal massage during the later stages of pregnancy. Here’s how to do that.

How to do perineal massage for pregnancy

If you’ve never attempted to give yourself a massage involving the area between your anus and vaginal opening, you may need some instructions on how to do a perineal massage for pregnancy — although even if you do have non-preggo prior experience, that resident in your uterus will make things a little trickier this time around. Basically, a perineal massage involves stretching and manipulating your perineal tissue using one or two fingers, typically belonging to you or a partner (or an extremely devoted friend). The idea is to train the tissue in the area for the big birthing event by stretching it, in the hopes that during delivery, it will stretch instead of tear. Or, if the perineum does tear, that it’s not as severe as it would be otherwise.

A quick warning: Even though it’s billed as a “massage” and involves parts of you that you might associate with more pleasurable activities, perineal massage can burn and feel uncomfortable at first, though supposedly you’ll get used to it. Here’s how to do it:

• Sit with your legs apart and your back supported. If this is a DIY job, having a hand mirror handy (so you can see what you’re doing) might help. Otherwise, you can put your perineum in your partner’s hands… well, fingers.
• It should go without saying that no matter who is doing the massaging, they absolutely must thoroughly wash their hands before getting started.
• With clean hands, put some type of lubricant on your fingers. (More on that in a minute.)
• Place a thumb or finger about 2 inches into your vagina, and use it to gently stretch the wall out to the side. Call this 3 o’clock.
• Still pressing and stretching outward, sweep down to 6 o’clock and over to 9 o’clock.
• Repeat for a total of 4 or 5 minutes.

When to start perineal massages

According to information from the University of Michigan Health System, you should start perineal massage around 34 weeks pregnant and do it three to four times a week for about five minutes. That’s all it takes for this type of childbirth-prep to be effective. And, really, that’s nothing if you think about the time it takes to heal if you have a perineal tear or episiotomy, right?

Which oils to use for perineal massage

The idea behind some type of lubricant here is the same as in other activities that occur in this general area: It helps reduce friction and make you more comfortable. In fact, you can go ahead and use a water-soluble lube like K-Y Jelly or Astroglide. If you have a lubricant of choice, it may be a good idea to bust that out since you’ll (likely) know that it’s not going to cause an allergic reaction. Otherwise, natural oils — including organic sunflower, grapeseed, coconut, almond, olive, or vitamin E oil — could all work. Just make sure to stay away from synthetic oils or lubricants, like baby oil, mineral oil, or petroleum jelly.

A little something to lighten the mood

If you’re curious about trying perineal massage but feel a bit anxious at the prospect, that’s entirely understandable. Pregnancy and childbirth definitely have a way of pushing you outside of your comfort zone. So, why not warm up to the idea with a little bit of laughter? For your viewing pleasure, enjoy this hilarious clip about perineal massage from the movie Baby Mama: