A Step by Step Guide for Perineal Massage

Expecting a baby? A Step by Step Guide for Perineal Massage

Did you know perineal massage has been shown to decrease the likelihood of perineal trauma (mainly episiotomies) during birth and reduce ongoing perineal pain postpartum?


But you’re probably asking yourself….

How do I even start?

How do I do it?

How often should I do it?

Working in women’s health physiotherapy we realize that many expecting mamas are not told about this valuable and important technique and every day we see their confused faces when we mention perineal massage-  so here it is!

A step by step guide for perineal massage.




Why do we do it?

The goal of perineal massage is to increase tissue elasticity (stretch) in order to reduce tearing during vaginal birth- as we know that the rates of perineal tearing among first time moms in Canada is very high. About 80% of first time Mom’s experience some form of perineal tearing.


What does the research say?

A 2013 review by Beckman & Stock (2013) concluded that digital perineal massage reduces the likelihood of perineal trauma (mainly episiotomies) and ongoing perineal pain postpartum and is generally well accepted by women. As such, women should be made aware of the likely benefit of perineal massage and provided with information on how to massage.


So How do I do it?

  1. Get comfortable. Lay in a semi-reclined position in your bed with your knees bent. Make sure you relax! Being as relaxed as possible is essential.
  2. Use clean hands, with trimmed, short fingernails and a goodwater-based orsilicon based lubricantClick the links to check out some of our faves.
  3. Picture your vaginal opening being a clock face. The bottom of the vagina is 6 o’clock and the top is 12 o’clock.
  4. Using your pointer finger or thumb (most patients prefer their thumb) take a nice deep breath, relax and insert the tip of your finger/thumb in the vaginal opening to the first knuckle.
  5. Starting at 6 o’clock take a nice big breath and as you relax apply a stretch downward toward the number 6.
  6. The stretch should be strong, stingy maybe, and slightly uncomfortable but not painful. We want to ensure we are actually stretching the pelvic floor and perineum.
  7. Hold for ~ 30 seconds.
  8. Move to number to 7 on your clock face. Repeat the stretch at each number of the clockface until you’ve worked your way around.
  9. As you move up to around 9 o’oclock it is sometimes easier to switch to your finger v.s. the thumb
  10. Start with 3 minutes and work up to 10 minutes. Practice 3-5x/a week.
  11. As you practice this it should get noticeably easier to do the stretching.
  12. As it gets easier increase your pressure, or add stretch in two directions using both thumbs/finger.


One Last thing.

As always, although we are physiotherapists, we are not YOUR physiotherapist. Perineal massage is not always advised in some cases. So make sure you check with your physician or healthcare provider before starting at around 36 weeks.


There you have it ! Your DIY playbook for perineal massage

If you’re more visual we also created this awesome video to get you started. Sign up here to have it delivered to your inbox.

Have questions or interested in learning more? Our entire online course Prenatal Pelvic Health: Core & Pelvic Floor Basics was designed to guide you through pregnancy, birth & postpartum with your core and pelvic floor in mind. It guides you through 8 modules related to core and pelvic health that you can complete at your own pace from the comfort of your couch.

Or if you’re having trouble? Book an appointment with one of us. 

Or reach out to a pelvic floor physiotherapist in your area.

Have a friend who’s expecting? Share this post with them.



Reference. Beckmann, M. & Stock, O. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev. 2013; (4): CD005123. Published online 2013 Apr 30. doi: 10.1002/14651858.CD005123.pub3




(Please note: We do receive a small commission if you purchase products using the links in this blog. Just like we would if you purchased a product at our clinic.)



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