The effect of perineal massage during pregnancy on perineal trauma and postnatal pain among women referred to Beasat Hospital, Sanandaj

The Effect of Perineal Massage during the Second Stage of Birth on Perineal Lacerations, Episiotomy, and Perineal Pain in Nulliparous Women

Introduction: Childbirth and puerperium are of the most important periods in women’s life and can affect different aspects of their life . Although childbirth is a physiological process, there is a risk of perineal trauma when neonate’s head is exiting, and thus, an episiotomy may be needed. This study was conducted to determine the effect of perineal massage in the second stage of labor on perineal lacerations, episiotomy, and perineal pain in nulliparous women going to childbirth unit of Besat Hospital in Sanandaj, Iran.
Material & Methods: The study population included all nulliparous women going to childbirth unit of Besat Hospital in 2013-2014. The participants were selected through convenience sampling and randomly assigned to groups such that nulliparous women with inclusion criteria were alternately assigned to the case and control groups. All of them were taught about postpartum perineal pain and its severity, and the researcher followed them up 3 days, 10 days, and 3 months after childbirth by telephone.

Results: The results showed mean and standard deviation of the participants in the case group (receiving perineal massage) as 25.62 ± 4.25 years and those in the control group as 25.31 ± 3.86 years. The participants in both groups were mostly 21-25 years old. The results revealed 23.16% of first-degree perineal laceration and 2.11% of second-degree perineal laceration in the case group, and no vestibular laceration and third- and fourth-degree lacerations in the case group. However, there were 5.13% of vestibular laceration, 7.69% of first-degree laceration, 2.56% of second-degree laceration, and 1.05% of third-degree laceration (one woman) in the control group.
Based on the results, the postpartum perineal pain was different in both group. Comparison of degrees of pain in the two groups showed that the severity of pain 3 days and 3 months after childbirth was significant (P = 0.01 & P = 0.008, respectively), but the severity of pain in the 10th day did not differ significantly (P = 0.78) (Table 5). The results on frequency of complications did not show any significant difference between groups (P = 0.413).
Conclusion: Regarding the results of this study and those of other studies, perineal massage during the second stage of labor can reduce the need to episiotomy, perineal injuries, and perineal pain.
Keywords: Perineal massage, Nuliparous, Laceration, Episiotomy, Second stage