Perineal massage during the last month of pregnancy can reduce the likelihood of perineal trauma (primarily episiotomies) and ongoing pain. Many authorities, including the World Health Organization (WHO), recommend prenatal perineal massage (PPM) during the second trimester of pregnancy to maintain the perineum intact and reduce the risk of severe perineal tears. PPM is generally advised from 34–36 weeks of pregnancy until delivery. Women are typically instructed to spend about 10 minutes regularly massaging their perineum. A Cochrane review (2013) published four trials involving 2,497 women and concluded that PPM was associated with a lower risk of severe perineal trauma and postpartum complications, especially for first-time mothers. One in 15 women who practiced PPM did not require perineal suturing after delivery. A 16% reduction in the incidence of episiotomies among women who practiced MPP. Less perineal pain at 3 months postpartum in multiparous women who received MPP. Women who practiced MPP found it acceptable and believed it helped them prepare for childbirth. 87% of women who practiced MPP said they would recommend it to another pregnant woman.