Perineal massage in the last weeks of gestation

• Vol 10 • July 2008 Perineal Massage to Prevent Perineal Trauma Perineal trauma is defined as any damage to the genitalia occurring during childbirth, either spontaneously or because of a surgical incision or episiotomy [1,2]. A large British study showed that 85% of women delivering vaginally will sustain some form of perineal trauma [3]. Over two-thirds of such women will require suturing. Genital tract lacerations after childbirth also weaken the pelvic floor muscles. Perineal trauma affects women’s physical, psychological, and social well-being in the immediate postnatal period as well as in the longer term. Possible deleterious effects include painful intercourse, urinary and fecal incontinence, and persistent perineal pain [2,4]. Thus, at 8 weeks after birth, 22% of new mothers reported continued perineal pain, and for some women, pain may persist for a year or longer [5]. The likelihood of perineal pain and sexual problems in the postpartum period is the least for women whose perineum remains intact [6]. Recently, several studies showed that perineal massage can reduce the likelihood of perineal trauma and ongoing perineal pain and is generally well accepted by women. This editorial will discuss the evidence for the beneficial effect of perineal massage on perineal trauma.