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Perineal massage effectively reduces perineal trauma and ongoing perineal pain

Lynn Griffith

Childbirth researcher Katherine Hartmann, MD, PhD, estimates that approximately 1 million episiotomies are performed in the United States yearly.  Out of these 1 million she estimates that fewer than 10 percent are medically warranted. (1)

Study reports that episiotomies intended benefits have no clinical evidence

A 2005 study from University of North Carolina reports that there is no evidence that episiotomies helped women avoid severe tears, or experience improved sexual function, or prevent childbirth-related incontinence.  (1)

Hartmann, director of research, reported, “Not only were we not achieving the ends that we had hoped for with routine episiotomy, but the evidence suggested that it might be causing harm in some cases.  With an episiotomy a woman will always need stitches. Women who don’t have the procedure may end up needing stitches, but they may not.” (1)

Perineal massage increases body elasticity and helps avoid tearing during childbirth

Research suggests that using perineal massage may increase muscle and tissue elasticity and avoid tearing during childbirth.  The recommendation of perineal massage for 10 minutes daily starting in the 34/35 week of pregnancy. (2)

A 2006 study, completed by Beckmann and Garrett, combined the results of four randomized, controlled trials involving a total of 2,497 pregnant women.  The study showed that women who participated in perineal massage had a 10 percent decrease in the risk of tearing.  First time mothers reported a 16 percent decrease in risk of tearing.  Second time mothers reported that they did not experience a reduced risk of perineal trauma but they did report a 32 percent reduce risk of ongoing perineal pain.  This study also reported that the more frequently these women used massage, the less likely they were to see benefits.  Women who received the most benefits completed perineal massage an average of 1.5 times per week and reported a 17 percent reduced risk of perineal trauma.  Women who used this technique 1.5-3.4 times per week experienced an 8 percent reduction in perineal trauma.  Women who completed perineal massage more than 3.5 times per week experienced no reduction in perineal trauma. (3)

A 2001 study from Paris concluded that antenatal perineal massage was a valid technique that reduced perineal trauma but recommended further research assessing women’s satisfaction with the technique. (4)

Leonid Kalichman, Pt PhD, completed a study in 2008 reviewing the effectiveness of perineal massage and also evaluated women’s satisfaction with this technique.  This 2008 study concluded that massage in the last week of gestation reduced the likelihood of perineal tearing and perineal pain.  The study also concluded that the practice was well accepted by women. (5)

When developing a birth plan, talk to your practitioner about techniques to avoid episiotomies.  It appears that there are benefits to using perineal massage to help reduce tearing and long-term perineal pain.  Using natural birthing techniques and pelvic floor exercises may help a laboring mother connect with her baby and help her be more aware of her perineum during the labor process. (6)

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