Perineal Massage and Episiotomy

Perineal massage involves gently massaging or stretching the area of skin between your vaginal opening and anus (perineum) in the last weeks before labor to prepare for childbirth. It helps you less likely to tear or get an episiotomy (a surgical incision of the perineum to quickly enlarge your vaginal opening for the baby to pass through.)

How often do perineal tears occur? 40% to 85% of all women who give birth vaginally will tear. About two thirds of these women will need stitches.

Are Episiotomies necessary?  An episiotomy is usually not necessary. However, sometimes your care provider may recommend an episiotomy. For example, an episiotomy can help if your baby needs to be born very quickly. Ask your health care provider to talk with you about episiotomies.

Can I do anything before the birth to help me avoid a tear?  Several studies have found that perineal massage during the last weeks of pregnancy can reduce tearing at birth. This massage— using two fingers to stretch your perineal tissues—is performed by you, in your home, once or twice daily, for the last 4 to 6 weeks of your pregnancy.

Are there any cautions when performing perineal massage? 

  • Avoid pressure on the urethra (at the top of the vaginal opening).
  • Massage gently.  Vigorous massage could cause bruising or swelling.
  • Do not massage if you have an active vaginal infection or herpes lesions.

Are there any risks to perineal massage during pregnancy? Not that we know of. It is free. It doesn’t hurt. It is easy to do. And most women don’t mind doing it. However, you should check with your health care provider before beginning perineal massage.  And, if you believe your bag of waters is leaking, check with your health care provider before putting anything in your vagina.

“With the new baby on the way, I strongly recommend the following books for your family.” -Angela

References and Resources