Skip to main content

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

Abstract

Purpose

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).

Method

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, access via your institution.

References

  1. Cleary-Goldman J, Robinson JN (2003) The role of episiotomy in current obstetric practice. Semin Perinatol 27(1):3–12

    PubMed  Article  Google Scholar 

  2. Royal College of Obstetricians and Gynaecologists (2004). Setting standards to improve women’s health. Guideline No.23

  3. Lam KW, Wong HS, Pun TC (2006) The practice of episiotomy in public hospitals in Hong kong. Hong Kong Med J 12(2):94–98

    PubMed  CAS  Google Scholar 

  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. 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. American College of Obstetricians Gynecologists (2006) ACOG practice bulletin. Episiotomy. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol 107(4):957–962

    Google Scholar 

  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)

  8. Cuningham FC, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom KD (2005) Williams obstetric, vol 1, 22nd edn. Mc Graw-Hill, North America

    Google Scholar 

  9. Eason E, Labrecque M, Wells G, Feldman P (2000) Preventing perineal trauma during childbirth: a systematic review. Obstet Gynecol 95(3):464–471

    PubMed  Article  CAS  Google Scholar 

  10. Weeks JD, Kozak LJ (2001) Trend in the use of episiotomy in the United States: 1980–1998. Birth 28(3):152–160

    PubMed  Article  CAS  Google Scholar 

  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, Oxford

    Google Scholar 

  12. Klein MC (1988) Rites of passage: episiotomy and the second stage of labour. Can Fam Phys 34:2019–2025

    CAS  Google Scholar 

  13. Beckmann MM, Garrett AJ (2006) Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev, Issue 1. Art. No.: CD005123

  14. Labreque M, Eason E, Marcoux S (2000) Randomized trial of perineal massage and perineal symptoms three month after delivery. Am J Obstet Gynecol 182:76–80

    Article  Google Scholar 

  15. Woolley RJ (1995) Benefits risks of episiotomy: a review of the English-language literature since 1980. Part II. Obstet Gynecol Surv 50(11):821–835

    PubMed  Article  CAS  Google Scholar 

  16. Johanson R (2000) Perineal massage for prevention of perineal trauma in childbirth. Lancet 355:250–251

    PubMed  Article  CAS  Google Scholar 

  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 27

    PubMed  Article  Google Scholar 

  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):143–160

    PubMed  Article  CAS  Google Scholar 

  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):269–276

    PubMed  Article  CAS  Google Scholar 

  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):365–372

    PubMed  Article  Google Scholar 

  21. Stamp G, Kruzins G, Crowther C (2001) Perineal massage in labour and prevention of perineal trauma: randomised controlled trial. BMJ 322(7297):1277–1280

    PubMed  Article  CAS  Google Scholar 

  22. Zhai H, Maibach HI (1998) Moisturizers in preventing irritant contact dermatitis: an overview. Contact Dermatitis 38:241–244

    PubMed  Article  CAS  Google Scholar 

  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. 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 31:128–133

    PubMed  Article  CAS  Google Scholar 

  25. Kalichman L (2008) Perineal massage to prevent perineal trauma in childbirth. Isr Med Assoc J 10(7):531–533

    PubMed  Google Scholar 

  26. Olds SB, London ML (2004) Maternal-newborn nursing and women’s health care, 7th edn. Pearson Prentice Hall, Columbus

    Google Scholar 

  27. Labrecque M, Eason E, Marcoux S (2001) Women’s views on the practice of prenatal perineal massage. Br J Obstet Gynaecol 108:499–500

    Article  CAS  Google Scholar 

  28. Leifer G (2008) Maternity nursing: an introductory text, 10th edn. Saunders Co, Philadelphia

    Google Scholar 

  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):787–791

    PubMed  Article  CAS  Google Scholar 

  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):499–502

    PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zohreh Khakbazan.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Geranmayeh, M., Rezaei Habibabadi, Z., Fallahkish, B. et al. Reducing perineal trauma through perineal massage with vaseline in second stage of labor. Arch Gynecol Obstet 285, 77–81 (2012). https://doi.org/10.1007/s00404-011-1919-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-011-1919-5

Keywords

  • Episiotomy
  • Perineal tear
  • Perineal massage
  • Vaseline
  • Vaginal delivery