Perineal Massage and Reduction in Perineal Trauma During Vaginal Delivery
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Authors
Booth, Jane
Date of Issue
2023-04-28
Type
Presentation
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Abstract
During vaginal childbirth, the region between the vulva and the anus, also known as the perineum, is susceptible to trauma due to stretching and tearing as the baby's head emerges, often resulting in lacerations, especially for nulliparous women, women who’ve never given birth before. Furthermore, episiotomies are procedures that are often performed during vaginal childbirth in which a surgical incision is made from the vagina into the perineum to attempt to prevent tissue rupture and help with difficult or fast births. Unfortunately, these often result in further tearing, more blood loss, infection, and postpartum pain (Ramar and Grimes, 2022). As for incidence, vaginal deliveries in the United States totaled 2,486,856 in 2021 (CDC, 2023). Over 85% of women that deliver vaginally experience some degree of laceration and/or episiotomy, increasing to 90.4% for those that are nulliparous or primiparous (Smith, 2013). Perineal massage (PM) is an intervention that can be performed during pregnancy to prepare the perineum for childbirth by stretching and softening the tissues in the perineum, making it more flexible and reducing the risk of trauma during delivery (Ramar and Grimes, 2022). The purpose of this evidenced based practice review is to examine the effects of PM compared to no PM on nulliparous/primiparous women delivering vaginally. Nurses or other healthcare providers can use this information to see if perineal massage is a beneficial intervention that can improve health outcomes in women during childbirth and reduce the incidence of perineal trauma.