Archives of Gynecology and Obstetrics

, Volume 285, Issue 1, pp 77–81 | Cite as

Reducing perineal trauma through perineal massage with vaseline in second stage of labor

  • Mehrnaz Geranmayeh
  • Zahra Rezaei Habibabadi
  • Bijan Fallahkish
  • Mahdi Azizabadi Farahani
  • Zohreh KhakbazanEmail author
  • Abbas Mehran
Materno-Fetal Medicine



Maintaining an intact perineum is a highly regarded aim in delivery procedures today. Since perineal massage is a common practice during delivery, the present study aims to investigate the effect of perineal massage with Vaseline on perineal trauma (rate of episiotomy procedures and perineal tears).


Ninety primiparous women (aged between 18 and 30 years with gestational age of 38–42 weeks) were selected sequentially in Tehran in 2009. Once participants’ characteristics were registered, they were randomly assigned to the intervention (perineal massage with Vaseline) or control groups. In the massage group, perineal massage was performed in the second stage of delivery once the genitalia were treated with sterilized Vaseline. The perineum was examined after the delivery in terms of episiotomy or tear and its severity degree.


The two groups were homogeneous in terms of demographic data, weight gain during pregnancy, gestational age, abortion history and fetal weight. The second stage of delivery was significantly shorter in the massage group than the control group and the massage group had significantly more intact perineum (P = 0.004). In addition, lower episiotomy and higher first- and second-degree perineal tears were seen in the massage group in comparison with the control one (P < 0.001). Neither of the groups suffered from third- and fourth-degree tears.


The findings showed that the perineal massage with Vaseline in the second stage of labor increases perineal integrity and decreases perineal traumas (episiotomy and tears). So, it seems that the perineal massage could be an effective way to preserve an intact perineum in labor.


Episiotomy Perineal tear Perineal massage Vaseline Vaginal delivery 


Conflict of interest



  1. 1.
    Cleary-Goldman J, Robinson JN (2003) The role of episiotomy in current obstetric practice. Semin Perinatol 27(1):3–12PubMedCrossRefGoogle Scholar
  2. 2.
    Royal College of Obstetricians and Gynaecologists (2004). Setting standards to improve women’s health. Guideline No.23Google Scholar
  3. 3.
    Lam KW, Wong HS, Pun TC (2006) The practice of episiotomy in public hospitals in Hong kong. Hong Kong Med J 12(2):94–98PubMedGoogle Scholar
  4. 4.
    Sh NavabiRigi, Abedian Z, Poorjavad M, Esmaeli H (2007) Evaluation the cooling gelpad and ice pack on wound healing and intensity perineal pain after episiotomy in primiparous women. Zahedan J Res Med Sci 9(1):30–35 [Persian]Google Scholar
  5. 5.
    Khajavi Shojaei K, Davati A, Zayeri F (2009) Frequency and side effect of episiotomy in primiparous women: a three-month longitudinal survey. Qom University Med Sci J 3(2):47–50 [Persian]Google Scholar
  6. 6.
    American College of Obstetricians Gynecologists (2006) ACOG practice bulletin. Episiotomy. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol 107(4):957–962Google Scholar
  7. 7.
    Ratchadawan S, Jadsada T, Pisake L, Witoon P, Jeerichuda P, Kanok S, et al. (2007) The outcomes of midline versus medio-lateral episiotomy. Reprod Health Oct 29;4(10)Google Scholar
  8. 8.
    Cuningham FC, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom KD (2005) Williams obstetric, vol 1, 22nd edn. Mc Graw-Hill, North AmericaGoogle Scholar
  9. 9.
    Eason E, Labrecque M, Wells G, Feldman P (2000) Preventing perineal trauma during childbirth: a systematic review. Obstet Gynecol 95(3):464–471PubMedCrossRefGoogle Scholar
  10. 10.
    Weeks JD, Kozak LJ (2001) Trend in the use of episiotomy in the United States: 1980–1998. Birth 28(3):152–160PubMedCrossRefGoogle Scholar
  11. 11.
    Enkin M, Keirse MJNC, Neilson J, Crowther C, Duley L, Hodnett E et al (eds) (2000) A guide to effectivec are in pregnancy and childbirth. Oxford University Press, OxfordGoogle Scholar
  12. 12.
    Klein MC (1988) Rites of passage: episiotomy and the second stage of labour. Can Fam Phys 34:2019–2025Google Scholar
  13. 13.
    Beckmann MM, Garrett AJ (2006) Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev, Issue 1. Art. No.: CD005123Google Scholar
  14. 14.
    Labreque M, Eason E, Marcoux S (2000) Randomized trial of perineal massage and perineal symptoms three month after delivery. Am J Obstet Gynecol 182:76–80CrossRefGoogle Scholar
  15. 15.
    Woolley RJ (1995) Benefits risks of episiotomy: a review of the English-language literature since 1980. Part II. Obstet Gynecol Surv 50(11):821–835PubMedCrossRefGoogle Scholar
  16. 16.
    Johanson R (2000) Perineal massage for prevention of perineal trauma in childbirth. Lancet 355:250–251PubMedCrossRefGoogle Scholar
  17. 17.
    Sanders J, Peters TJ, Campbell R (2005) Techniques to reduce perineal pain during spontaneous vaginal delivery and perineal suturing: a UK survey of midwifery practice. Midwifery 21(2):154–160 Epub 2005 Mar 27PubMedCrossRefGoogle Scholar
  18. 18.
    Renfrew MJ, Hannah W, Albers L, Floyd E (1998) Practices that minimize trauma to the genital tract in childbirth: a systematic review of the literature. Birth 25(3):143–160PubMedCrossRefGoogle Scholar
  19. 19.
    Albers LL, Anderson D, Cragin L, Daniels SM, Hunter C, Sedler KD, Teaf D (1996) Factors related to perineal trauma in childbirth. J Nurse Midwifery 41(4):269–276PubMedCrossRefGoogle Scholar
  20. 20.
    Albers LL, Sedler KD, Bedrick EJ, Teaf D, Peralta P (2005) Midwifery care measures in the second stage of labor, reduction of genital tract trauma at birth: a randomized trial. J Midwifery Womens Health 50(5):365–372PubMedCrossRefGoogle Scholar
  21. 21.
    Stamp G, Kruzins G, Crowther C (2001) Perineal massage in labour and prevention of perineal trauma: randomised controlled trial. BMJ 322(7297):1277–1280PubMedCrossRefGoogle Scholar
  22. 22.
    Zhai H, Maibach HI (1998) Moisturizers in preventing irritant contact dermatitis: an overview. Contact Dermatitis 38:241–244PubMedCrossRefGoogle Scholar
  23. 23.
    Atarha M, Vakilian K, Akbari Torkestani N, Heydari T, Bayatian Y (2009) Effect of perineal massage during second phase of labor on episiotomy and laceration rates among nulliparous women. Hayat 15(2):15–22 [Persian]Google Scholar
  24. 24.
    Avery M, Burket B (1986) Effect of perineal massage on the incidence of episiotomy and perineal laceration in a nurse midwifery service. J Nurse Midwifery 31:128–133PubMedCrossRefGoogle Scholar
  25. 25.
    Kalichman L (2008) Perineal massage to prevent perineal trauma in childbirth. Isr Med Assoc J 10(7):531–533PubMedGoogle Scholar
  26. 26.
    Olds SB, London ML (2004) Maternal-newborn nursing and women’s health care, 7th edn. Pearson Prentice Hall, ColumbusGoogle Scholar
  27. 27.
    Labrecque M, Eason E, Marcoux S (2001) Women’s views on the practice of prenatal perineal massage. Br J Obstet Gynaecol 108:499–500CrossRefGoogle Scholar
  28. 28.
    Leifer G (2008) Maternity nursing: an introductory text, 10th edn. Saunders Co, PhiladelphiaGoogle Scholar
  29. 29.
    Shipman MK, Boniface DR, Tefft ME, McCloghry F (1997) Antenatal perineal massage, subsequent perineal outcomes: a randomised controlled trial. Br J Obstet Gynaecol 104(7):787–791PubMedCrossRefGoogle Scholar
  30. 30.
    Mei-dan E, Walfisch A, Raz I, Levy A, Hallak M (2008) Perineal massage during pregnancy: a prospective controlled trial. Isr Med Assoc J 10(7):499–502PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Mehrnaz Geranmayeh
    • 1
  • Zahra Rezaei Habibabadi
    • 1
  • Bijan Fallahkish
    • 2
  • Mahdi Azizabadi Farahani
    • 2
  • Zohreh Khakbazan
    • 1
    Email author
  • Abbas Mehran
    • 1
  1. 1.Nursing and Midwifery SchoolTehran University of Medical SciencesTehranIran
  2. 2.TehranIran

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