Massage Cuts Need for Episiotomies
Fewer Episiotomies Needed With Pre-Birth Perineal Massage
Jan. 24, 2006 -- Women who massage their perinea before childbirth have
fewer episiotomies, according to a new report.
What are perinea? It's one of those body parts nobody knows the name of. The
perineum is the muscular area just below the vagina. It's the part of the body
that has to stretch during childbirth.
Sometimes the perineum tears during delivery. Minor tears can be painful but
rarely lead to lasting problems. But major tears can mean long-term trouble.
That's why doctors sometimes make a cut in the perineum -- an episiotomy.
However, there's good evidence that routine episiotomies don't help.
Midwives often recommend massaging the perineum during the last weeks of
pregnancy. Can it help?
Yes, find Michael M. Beckmann, MD, and Andrea J. Garrett of the QE2 Jubilee
Hospital in Queensland, Australia. They analyzed data from three studies of
"Perineal massage during the last month of pregnancy ... undertaken by the
woman or her partner for as little as once or twice a week ... reduced the
likelihood of perineal trauma (mainly episiotomies) and ongoing perineal
pain," Beckmann and Garrett write.
They report their findings in the Jan. 25 online issue of The Cochrane
Database of Systematic Reviews.
How to Do It
The researchers found that for every 16 women who practice perineal massage,
one will avoid needing stitches to repair her perineum after birth. This
benefit applied only to women having a first vaginal pregnancy -- although
Beckmann and Garrett suggest that women might benefit during later pregnancies,
Overall, this group of women who practiced perineal massage had 15% fewer
episiotomies than those who did not.
How is it done? The woman herself or her partner can give the massage. These
are the instructions given in one of the studies:
"Woman or partner performed daily 5- to 10-minute perineal massage from
34 weeks [of pregnancy]. One or two fingers are introduced 5 centimeters [about
2 inches] into the vagina, applying alternating downward and sideward pressure
using sweet almond oil."
Beckmann and Garrett note that there are now "massage devices" for
perineal massage. Unfortunately, none of these devices has been studied in
clinical trials, so they don't know whether they work as well as manual