Studies show that women can reduce the risk of muscle tears and stitches by practicising regular perineal massage in the last 4 to 6 weeks of pregnancy (especially with their first baby).

Perineal massage lets you experience some of the stretching sensations felt during the crowning stage of labour when PFMs are under maximal stretch. Perineal massage has two benefits: it increases the extensibility of PFMs before labour and you learn to keep the PFMs relaxed under stretch.

Practice the following massage or ask your partner for help if you both feel comfortable.

  • Wash hands and trim thumbnails.
  • Relax in a warm bath or apply hot towels to relax the PFMs.
  • Apply cold pressed oil or non-petroleum based lubricant to the perineum – the area between vagina and anus.
  • Squat on a low padded stool or propped up in bed.
  • With thumbs hooked inside the vagina, slowly stretch down towards the anus and out to each side until you feel a stretching, tingling sensation. This opening action stretches the skin and muscles in a similar way the baby’s head stretches them during birth. Avoid the urethral opening.
  • Feel yourself ‘letting go’ as the perineum is stretched, rather than reacting by tightening and closing the PFMs. Breathe with a relaxed jaw.
  • Initially hold the stretch for 30 seconds then relax for a minute. Lengthen the stretch time and intensity up to 90 seconds over the next week. Repeat several times, twice a day after 34 to 36 weeks of pregnancy.
  • Don’t perform perineal massage if herpes or other sexually transmitted diseases are active.

Consult your midwife if you need help to learn or perform the massage.