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Perineal massage in labour fails to prevent perineal damage

Perineal massage in labour and prevention of perineal trauma: randomised controlled trial

Damage to the perineum (the area between the genital organs and the anus) during vaginal birth affects the sexuality, self esteem and quality of life of countless women every year. However, a study in this week's BMJ finds that perineal massage during labour does not have any effect on the likelihood of an intact perineum or reduce the risk of persistent pain, sexual, urinary and faecal problems after childbirth.

Over 1300 women expecting a normal vaginal birth of a single baby were randomised into two groups. Women in the intervention group received massage and stretching of the perineum with each contraction during the second stage of labour. For women in the control group, midwives were instructed to use their usual technique, but to refrain from using perineal massage.

The research team found no benefit from massage on rates of intact perineums and damage, pain, or urinary, faecal, and sexual problems. There were fewer serious (third degree) tears in the massage group, but larger trials are needed to assess whether massage can protect against the risk of this rarer outcome, add the authors.

Despite these findings, this trial does show that perineal massage is not harmful, and that in itself may be of value, say the authors. "We suggest that midwives follow their usual practice while taking into account the preferences of individual women," they conclude.

Contact:

Georgina Stamp, Senior Research Fellow (Adjunct), University of South Australia, Adelaide, Australia Email: georgie.stamp@unisa.edu.au

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