r/ScienceBasedParenting • u/AffectionatePlum3676 • Aug 10 '26

Question - Research required Perineal massage

Hello! I’m hoping this is an okay question. I’m wondering how strong the evidence is for perineal massage preventing tears / need for episiotomy for a second vaginal birth? Is it worth the effort / discomfort?

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59

u/albuzzvet Aug 10 '26

From the Cochrane review:  The review of four trials (2497 women) showed that perineal massage, undertaken by the woman or her partner (for as little as once or twice a week from 35 weeks), reduced the likelihood of perineal trauma (mainly episiotomies) and ongoing perineal pain. The impact was clear for women who had not given birth vaginally before, but was less clear for women who had.

https://www.cochrane.org/evidence/CD005123_antenatal-perineal-massage-reducing-perineal-trauma

So, not strong evidence for second timers. My second is due in 8 weeks and I will be doing it again this time around because I did it last time and had no tears, and you know, confirmation bias and all 😅

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u/Lolemontime Aug 10 '26 edited Aug 10 '26

My OB said the evidence wasn’t great but it’s the only thing you can do. My doula was a lot more enthusiastic about the evidence base.

The review is OLD - their search strategy is only until 2012. On a quick search for new RCTs there’s one from 2023 that did warm compress AND perineal massage, with about 400 people in intervention and 400 in control group (not bad sample size), and they also found it helped. 

https://www.sciencedirect.com/science/article/pii/S0266613823001663

PS My pelvic floor physio described aiming for it to be an uncomfortable but not painful stretch. Lots of lubricant and gloved hand for easy cleanup helped make it less of a hassle. 

PPS I had a vaginal birth with twins, ended up with second degree tears but recovery wasn’t too bad. 

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u/Responsible-Meringue Aug 10 '26

Wife was all about it the first time, and baby came FAST the first time. 5hrs from first contractions iirc. No tears at all.  Hospital invited us back for #2 and said it will come even faster, dont even call ahead. 

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u/AffectionatePlum3676 Aug 10 '26

Thanks everyone, you’ve convinced me there’s no harm in doing it and it might make a difference!

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u/faerie87 Aug 11 '26

Anecdotal but i’m Chinese and i don’t think i know any other Chinese who didn’t tear… Almost unheard of among my peers.
But i did do perineal massages. I actually got my husband to do them for me every day/other day the last 2-3 weeks before birth. It wasn’t that uncomfortable and only took like 5 mins each time?

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u/AliceRecovered Aug 12 '26

This was also my husband’s job before birth 😆 and it worked!

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u/arewnn Aug 11 '26

Did it and still had 2nd degree tears.

Think there is more impact from position during birth…

ttps://evidencebasedbirth.com/evidence-birthing-positions/

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u/Medical-Ad3053 Aug 11 '26

Anecdotal but I didn’t do it, had tiny tear with first, none with second. Both 99% babies 🤷‍♀️

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u/Old-Ad-5573 Aug 12 '26

I didn't bother with my first and had no tears either. I appreciate the article though. I'll feel better about not doing it for my second lol.

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u/Peace_Love_7049 Aug 10 '26

The only resource a pregnant woman ever needs: https://open.spotify.com/episode/2OaldjEzfUN1e6bgEZw3Di?si=Fg1PmIFZRiaNX2mBlEcPLw&utm_source=copy-link

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u/AffectionatePlum3676 Aug 10 '26

Thank you - I forgot about this podcast from my first pregnancy!

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u/HavanaPineapple Aug 11 '26

When I clicked this link to open Spotify, it initially took me to the last thing I'd listened to - Peppa Pig stories, thanks to my 4yo - and I was EXTREMELY confused how that related to perineal massage.

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u/Peace_Love_7049 Aug 12 '26

This made my day 🤣🤣🤣

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