Antenatal perineal massage for reducing perineal trauma

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Perinatal Care

Background:

• Perineal trauma during vaginal birth can lead to significant short- and long-term maternal morbidity.
• Antenatal perineal massage is a proposed method to reduce the incidence of such trauma.

Purpose of the Study:

• To evaluate the impact of antenatal perineal massage on the incidence of perineal trauma and subsequent morbidity following vaginal birth.

Main Methods:

• A systematic review of randomized and quasi-randomized controlled trials was conducted.
• Searches included major databases like Cochrane, PubMed, and EMBASE up to January 2005.
• Three trials involving 2434 women met the selection criteria for antenatal perineal massage in the last four weeks of pregnancy.

Main Results:

• Antenatal perineal massage significantly reduced the need for suturing due to perineal trauma (RR 0.91, NNT 16), primarily in women without prior vaginal births.
• The practice also decreased the likelihood of episiotomy (RR 0.85, NNT 23), again most notably in nulliparous women.
• A significant reduction in perineal pain at three months postpartum was reported by women who had previously given birth vaginally (RR 0.68, NNT 13).

Conclusions:

• Antenatal perineal massage is effective in lowering the incidence of perineal trauma, particularly episiotomies.
• It also reduces the reporting of persistent perineal pain postpartum and is well-accepted by women.
• Healthcare providers should inform women about the benefits and techniques of antenatal perineal massage.