Perineal Tears: What They Are and How to Lower the Severity

When someone gives birth vaginally, the skin and muscles around the vaginal opening (aka the perineum) can sometimes tear as the baby is born. These “perineal tears” are very common, but there are safe, research-backed ways to lower the chances of having a more severe tear. Two of the best-supported tools are perineal massage and using warm compresses during pushing. Let’s talk about each, so you feel comfortable using them at home!

What is a Perineal Massage

Perineal massage is a gentle way to stretch and prepare the vaginal tissues before birth. Research shows that doing perineal massage in the last few weeks of pregnancy (around 34-36 weeks gestation) can make the tissues more flexible and may reduce the chances of needing an episiotomy (a surgical cut) or having a severe tear. This is especially true for people giving birth for the first time.

A perineal massage can be done with your hands, but some people prefer to use a tool, such as a perineal massage wand, to help reach the area more comfortably. Brands like Frida Mom or Intimate Rose offer wands designed for this purpose at a relatively low cost. While studies on wands themselves are still limited, the overall evidence strongly supports the benefits of perineal massage.

Warm Compresses During Pushing

Another helpful tool is applying a warm compress (like a washcloth soaked in warm water) to the perineum during the pushing stage of labor. Large studies and reviews show this simple step can lower the risk of third- and fourth-degree tears, reduce pain in the first few days after birth, and sometimes lower the need for stitches. Warm compresses are safe, affordable, and easy for nurses or midwives to use during delivery.

Put It All Together for Childbirth Support from a Women’s Physical Therapy & Wellness Clinic

Both perineal massage during pregnancy and warm compresses during pushing are safe, low-cost ways to protect the perineum. When combined with other gentle birth practices like breathwork and support from your care team, these tools can make a real difference in recovery after birth!

Call 515-882-0800 or email contactus@breatheptw.com to schedule your consultation with one of our expert physical therapists! Virtual appointments available throughout Iowa.

Breathe. Physical Therapy & Wellness is a two-clinic holistic physical therapy practice in West Des Moines and North Liberty specializing in dry needling, Diastasis Recti Abdominus, Incontinence, women’s health, pregnancy/postpartum pain/recovery and pelvic floor dysfunction. 

*Disclaimer: This post is educational and not medical advice. Please consult your medical provider for information specific to your needs.