Podcast Episode #232
Preparing the pelvic floor for birth [Part 2/3]-Perineal tears, perineal massage
Today’s episode is part 2 of 3, where I discuss ways to prepare the pelvic floor for birth.
In part 1 (episode 228) I discuss the impact of pelvic floor awareness during pregnancy.
In today’s episode, I discuss evidence-based ways to help reduce pelvic floor trauma as a result of vaginal birth.
Over 81 % of women in Australia will have a perineal tear or episiotomy during their first vaginal delivery.
The majority of these are relatively minor first degree tears or second degree tears.
Only around 3% of women in Australia will experience a 3rd or 4th degree tear (a tear that extends into the anal spincter).
Luckily, there are evidence-based ways that you can reduce the severity or risk of perineal trauma.
Listen to this episode where I talk through perineal massage, perineal preparation for childbirth and other ways to help support the pelvic floor area during and after birth.
Reference: Abdelhakim et al, 2020: Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta analysis of randomised controlled trials.

In this article you'll find tips to:
- Understand what perineal massage is and why it’s beneficial for childbirth.
- Perform perineal massage safely and effectively at home.
- Reduce the risk of perineal tears and episiotomies during vaginal birth.
- Enhance your recovery from birth with perineal massage.
- Support better wound healing and reduce perineal pain post-delivery.
- Relax your pelvic floor muscles to prepare for a smoother childbirth experience.
- Incorporate additional techniques to minimise the risk of severe perineal trauma.
- Use perineal massage to feel more confident and empowered about your body’s ability to give birth.

In this episode of the Pregnancy, Birth, and Recovery podcast, I explore the benefits of perineal massage as part of birth preparation. We dive into how this simple yet powerful technique may help reduce the risk of tearing during childbirth, support postnatal recovery, and empower women to feel confident in their bodies during this pre and postnatal journey.
Particularly if you’re a first-time mum or perhaps you have been through childbirth before, understanding perineal massage may make a significant difference in your experience. Let’s explore what it is, how to do it, and how it can support you during and after birth.
What is Perineal Massage?
Perineal massage is a technique that involves gently stretching and massaging the perineum—the area between the vagina and anus. It’s designed to prepare this area for childbirth, reducing the likelihood of 3rd and 4th degree tears or the need for an episiotomy. The practice not only helps to stretch the skin and muscles but also increases awareness of the tension held in the pelvic floor, promoting relaxation during birth.
Research has shown that perineal massage can:
- Lower the risk of severe perineal tears (third- and fourth-degree).
- Reduce perineal pain after delivery.
- Improve wound healing.
- Shorten the second stage of labour.
How to Do Perineal Massage
Starting around 35–36 weeks of pregnancy, perineal massage can be performed at home or with the assistance of a partner. Here’s how to do it safely and effectively:
- Prepare:
- Wash your hands and ensure your nails are trimmed.
- Use a comfortable position, such as lying down or reclining with your knees bent.
- Apply a natural, unscented oil like almond oil to your hands and the perineal area.
- Massage:
- Insert your thumbs (or your partner’s fingers) about 2–3 cm into the vaginal opening.
- Press gently downwards towards the anus and outwards to the sides to create a stretching sensation.
- Use a U-shaped motion to massage the area for about 5 minutes, twice a week.
- Relax:
- Breathe deeply and try to release tension in your pelvic floor muscles as you massage. This helps mimic the relaxation needed during childbirth.
- Ensure a medical tick of approval:
- There are some medical conditions which means perineal massage may not be appropriate for you in your pregnancy journey. Check in with your healthcare provider to ensure perineal massage is safe for you to perform during pregnancy.
How Can Perineal Massage Help with Birth Outcomes?
The perineum naturally stretches during a vaginal birth, and it is in fact very common to receive a first or second degree perineal tear, which tend to heal very well with few long term complications. Perineal massage helps prepare the area by:
- Stretching the skin and muscles, making them more pliable for childbirth.
- Increasing awareness of the sensation of stretch, helping to reduce anxiety during labour.
- Lowering the risk of third- and fourth-degree tears, which may contribute to long-term complications like incontinence.
- Decreasing the likelihood of needing an episiotomy.
For first-time mothers, the benefits of perineal massage are particularly significant, as they have a higher risk of perineal trauma.
How Can Perineal Massage Help with Recovery from Birth?
Perineal massage doesn’t just help during childbirth—it also supports postnatal recovery by:
- Promoting better wound healing in the perineal area.
- Reducing perineal pain after delivery.
- Improving pelvic floor function by reducing tension in the muscles.
- Supporting quicker recovery of the perineal tissues after stretching during labour.
Incorporating this practice into your prenatal routine can make a significant difference in how your body feels post-birth.
Top Tips for Performing Perineal Massage
To get the most out of perineal massage for birth, follow these expert tips:
- Start at the Right Time: Begin perineal massage at 35–36 weeks of pregnancy. Consult your doctor or midwife to ensure it’s safe for your unique situation.
- Focus on Relaxation: Relax your pelvic floor muscles as you massage. Deep breathing and visualisation techniques can help.
- Be Gentle: Stretching should feel like a comfortable pressure, not pain. If you experience discomfort, reduce the intensity.
- Get a Partner Involved: If you’re comfortable, ask your partner to assist. Their involvement can make the process easier and foster connection.
- Use the Right Tools: Choose a suitable lubricant like almond oil, and ensure your hands are clean and nails are trimmed.
- Combine with Other Techniques: Pair perineal massage with regular pelvic floor exercises and relaxation strategies to maximise your preparation for birth.
- Join the free 7 day trial with FitNest Mama for a full video tutorial and physio support.
Perineal massage is a simple yet powerful tool for women preparing for childbirth. By reducing the risk of tears, enhancing recovery, and promoting pelvic floor health, it can help women feel confident and prepared for one of life’s most transformative experiences.
If you’re ready to learn more or try perineal massage, consider joining our 7 day free trial to FitNest Mama, which offers tailored guidance, demonstrations, and exercises for every stage of pregnancy.
** This podcast has general information only. Always seek the guidance of your doctor or other qualified health professional with any questions or concerns you may have regarding your health or medical condition.
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