Is Perineal Massage During Labor Recommended?

Perineal massage is commonly done in the last weeks of pregnancy to reduce the chances of perineal tearing or an episiotomy during childbirth. You may wonder if there are benefits to doing perineal massage during the process of labor itself.

During labor, perineal massage is usually done by the midwife. After inserting two fingers into the vagina, the midwife will press downwards towards the rectum and move the fingers side to side at the same time. 

 

There are studies that support perineal massage during labor

The effectiveness of perineal massage while the mother is in active labor has also been established in many studies. Here are a few of the studies that support the use of it during labor:

The World Health Organization (WHO) recommends doing perineal massage during labor. In their 2018 guidelines titled, Intrapartum Care for a Positive Childbirth Experience, they concluded that perineal massage and warm compresses may prevent tearing during childbirth. The French national college of obstetricians and gynecologists (CNGOF) also strongly recommend that perineal massage should be done if the mother agrees.

These recommendations have been further confirmed by a large meta-analysis from 2018. The study analyzed data collected from more than 3,000 women. They researchers found that the women who had the massage not only had fewer episiotomies, but they also had less trauma to their perineum.

An 2015 study from Turkey iarrived at the same conclusion: women who had the massage during active labor needed fewer episiotomies compared to women who did not have the massage.

 

One study did not support perineal massage during labor
(but didn’t discourage it either)

Not all studies agree on the benefits of perineal massage during labor. In 2001, Australian researchers performed a large study looking at the effects of the  massage during labor in 1,340 women. They found that perineal massage did not make any significant difference to childbirth and complications after delivery. While they could not recommend perineal massage based on their findings, they did not discourage it either. 
 

Conclusion: There is no evident  downside to perineal massage during labor

Perineal massage is a non-invasive procedure and there are seem to be no real downsides to doing it. If done by a trained midwife using a perineal massage oil, it should not cause harm to the mother or the baby and it could help.
 
If you are interested in trying out perineal massage during your delivery, talk with your midwife or doctor. It may be well worth doing, especially if this is your first pregnancy.
 
March 28, 2021