What is the recommended lubricant for perineal massage?

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Last updated: June 5, 2025View editorial policy

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From the Guidelines

For perineal massage, the recommended lubricant is a water-based lubricant, such as K-Y Jelly or Astroglide, as they are safe for use in the perineal area and do not weaken latex 1. When performing perineal massage, it is essential to choose a lubricant that provides adequate slipperiness to reduce friction during the massage while being safe for use in the perineal area.

  • Water-soluble lubricants, such as K-Y Jelly or Astroglide, are easily washed away and won't stain clothing.
  • These lubricants help reduce discomfort during the massage and allow for effective stretching of the tissues. Some key points to consider when selecting a lubricant for perineal massage include:
  • Avoiding petroleum-based products like Vaseline, as they can break down latex (if using gloves) and may increase the risk of infection 1.
  • Considering the use of water-based lubricants, which are safe for use with latex condoms and do not weaken them. Perineal massage is typically recommended from around 34 weeks of pregnancy, performed for about 5-10 minutes daily or several times weekly to help increase perineal elasticity and potentially reduce the risk of tearing during childbirth. The most recent and highest quality study 1 supports the use of water-based lubricants, such as K-Y Jelly or Astroglide, for perineal massage.

From the Research

Recommended Lubricant for Perineal Massage

  • The recommended lubricant for perineal massage is not explicitly stated in most studies, but some studies provide information on the lubricants used in their research.
  • A study published in 2020 2 found that perineal massage was usually done by a midwife in the second stage, during or between and during pushing time, with the index and middle fingers, using a water-soluble lubricant.
  • Another study published in 2020 3 used ostrich oil for perineal massage and found that it significantly decreased the rate of episiotomy compared to the control group.
  • A study published in 2013 4 compared the use of liquid wax (jojoba oil) versus purified formula of almond and olive oil, enriched with vitamin B1, B2, B6, E and fatty acids, and found no significant differences regarding perineal lacerations.
  • There is no consensus on the best lubricant to use for perineal massage, and more research is needed to determine the most effective and safe lubricant.

Types of Lubricants Used in Studies

  • Water-soluble lubricant 2
  • Ostrich oil 3
  • Liquid wax (jojoba oil) 4
  • Purified formula of almond and olive oil, enriched with vitamin B1, B2, B6, E and fatty acids 4

Effectiveness of Perineal Massage

  • Perineal massage has been shown to reduce the risk of severe perineal trauma, such as third and fourth degree lacerations 2.
  • Perineal massage can also reduce the incidence of episiotomy and improve the rate of intact perineum 2, 3, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Perineal massage during labor: a systematic review and meta-analysis of randomized controlled trials.

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2020

Research

Can we find the perfect oil to protect the perineum? A randomized-controlled double-blind trial.

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2013

Research

Efficacy of perineal massage during the second stage of labor for the prevention of perineal injury: A systematic review and meta-analysis.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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