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Is the use of perineal massage a useful technique for childbirth?

From: Jason Spah (sammydogone@hotmail.com)
Mon, 4 Feb 2002 21:02:07 -0600 (CST)

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The hypothesis that performing perineal massage during the second stage of childbirth will decrease the chances for perineum tears during delivery was interesting to me because it is very simple to perform and has no apparent side effects. Perineal tears during childbirth can result in multiple long-term urinary and gynecologic problems, including dyspareunia, and urinary and fecal incontinence (Walling 2001). If these simple exercises could reduce just a small number of perineal tears, then I feel as though these exercises should be practiced extensively. However, Cerrato (2001) stated, perineal massage does not seem to reduce the risk of perineal trauma during delivery. Cerrato (2001) found that there were not significant differences in the number of episiotomies or first and second-degree tears between the massage and control group. Stamp, Kruzins and Crowther (2001) also found that there was no differences in number of episiotomies or first and second degree tears, but they discovered that there was a trend towards a reduced risk for the rarer outcome of a third degree tear. According to Johnson (2000), the woman experienced a much larger benefit from perineal massage when she is over the age of 30.

I am curious how widely used perineal massage is in the current clinical field.

--
Jason Spah, Student Nurse at the University of North Dakota

References
Stamp, G., Kruzins, G., Crowther, C.(2001)Perineal massage in labour and
prevention of perineal trauma: Randomised controlled trial, British
Medical Journal, 322, 1277-1280
Walling, A.  D.(2001)Perineal massage during labor offers limited
benefit: American Family Physician,64(11)1888
Johanson, R.(2000)Perineal massage for prevention of perineal trauma in
childbirth: The Lancet, 355(9200)250-251

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