Written by a pelvic floor physical therapist at Empower Your Pelvis, in Kansas City, Missouri (Lee Summit, MO and Overland Park, KS)

The perineum is the tissue located between the vagina and anus, an area where many vaginal tears and episiotomies occur during childbirth. Preparing this tissue through perineal massage and stretching can improve blood flow, enhance tissue flexibility, and potentially reduce the risk of tearing or needing an episiotomy during labor.

While you can perform perineal massage on your own, a pelvic floor physical therapist can guide you through the process or assist if you're uncomfortable doing it alone.

When to Start Perineal Stretching

Perineal stretching can begin as early as 33-34 weeks of pregnancy. Many find it convenient to perform in the shower using a dilator or wand. To do this, try placing one foot on the shower ledge and gently stretch the pelvic floor on the side where your foot is elevated. Click here to see the dilators and wands I recommend. Use promo code AMANDA4 for $5 off.

If you'd rather have a partner help, try a semi-reclined position with pillows behind you or lie on your side for easier access.

Do You Need Lube?

Using lubrication is optional and can enhance comfort. Some women may have enough natural lubrication due to increased pregnancy discharge, while others may prefer water-based lubes like Slippery Stuff, SYLK, or Good Clean Love. Water from the shower can also work as a natural lubricant.

How to Perform Perineal Massage: Step-by-Step Guide

1. Get Oriented: Think of your vagina like a clock face. The area just under the urethra (towards the front) is 12 o'clock, the anus is at 6 o'clock, and the sides (towards your ischial tuberosities) are at 3 and 9 o'clock.

2. Massage the Tissue: Insert your fingers or a dilator/wand into the vagina. Gently stretch the tissue in a sweeping motion from 3 to 9 o'clock, focusing particularly between 3 and 6 o'clock, and 9 and 6 o'clock. The goal is to widen the vaginal opening. You can also gently pinch and pull the tissue between the vagina and anus—this area is where most tears or episiotomies occur during childbirth.

3. Consistency is Key: Perform this massage for about 3-8 minutes, 3-4 times a week, starting at 33-34 weeks of pregnancy. If you are considered high-risk, be sure to consult with your healthcare provider for guidance and consent.

Incorporating perineal massage into your prenatal routine can help prepare your body for childbirth. With regular practice, it can increase your comfort and potentially reduce the risk of perineal trauma.

Get Professional Help

If you're looking for “pelvic floor therapy near me”, consider scheduling a consultation at one of our locations in Kansas City-Overland Park, Kansas, or Lees Summit, Missouri. Click here to book your appointment.

Join the Body After Birth Program

Are you ready to take control of your postpartum recovery and tackle the challenges caused by pregnancy and childbirth? The Body After Birth program offers the comprehensive support you need to heal, strengthen, and thrive. Join today and start your journey to feeling your best, both inside and out!

With wellness in your pelvis-

Amanda Fisher, PT, DPT
Owner, Empower Your Pelvis, a pelvic floor physical therapy clinic in Kansas City (Lee’s Summit, MO and Overland Park, KS)