Massage Not Effective for Preventing Tearing During Labor
WebMD News Archive
Certified nurse midwives who spoke with WebMD had mixed opinions on the value of the method.
Perineal massage came into being based on word-of-mouth that it helped, not based on any scientific studies that it works, says Marion McCartney, CNM, director of professional services for the American College of Nurse-Midwives.
"My experience as a nurse midwife has been some people find massage helped them and others didn't want you to do that," she says. "Some people just want warmth up against them ... warm compresses [on the perineum] often make them feel much better. It's just personal preference."
In the study, a water-soluble lubricant was used on the perineum during the massage, but McCartney says nurse midwives use a variety of substances including olive oil and vitamin E.
McCartney says despite the study's findings, the real value of perineal massage for many women is the relaxation and comfort it can provide.
"Anything that makes her feel better is good because she does a better job of pushing her baby out," she says.
But Gretchen Mettler, CNM, MS, RN, says how the massage is performed usually determines whether a women in labor finds it comforting or helpful.
"I've seen it done pretty hard to the point where it hurt ... and where it causes [swelling] of the perineum, and that doesn't help," says Mettler, an instructor of nursing at Case Western Reserve University's Frances Payne Bolton School of Nursing in Cleveland.
Some midwives recommend having the mother perform perineal massage during the last month of her pregnancy, but not during labor, says Mettler, who has been a nurse midwife for 17 years and says she has assisted in more births without massage than with it. She says a better way to prevent tearing and take pressure off the perineum is to have women push between contractions instead of with the contractions.
"Then there is more of a chance for the perineum to slowly stretch out and not tear," she says.