Perineal Massage: A Supportive Practice in the Second Stage of Labor

Abstract

Background: Labor is defined as regular and painful uterine contractions that cause progressive dilation and effacement of the cervix. The labor has three clinical stages such as First stage (dilation of cervix up to 6cm), Second stage (complete dilation of the cervix 10 cm and ending with expulsion of the fetus), Third stage (delivery of placenta). Perineal injuries of varying degrees occur in 53–89% of women experiencing vaginal delivery, with the highest incidence in primiparous women and with 4% to 11% sustaining an obstetrical anal sphincter injury episiotomy a surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labor. It is a selective procedure rather than routine. It used to minimize overstretching and rupture of the perineal muscles and fascia to reduce the stress and strain on the fetal head. During the second stage of labor perineal massage is very effective in relaxing the perineum, reducing the perineal pain, preventing laceration and also helps in easier pushing of fetus from the floor of the pelvis by increasing the blood supply to perineum, increasing the elasticity of perineal muscle. Method: For this study the reference are taken from the randomized clinical trials (RCT) and systematic review, published over the last 10 years, on the perineal massage on second stage of labor. Conclusion: perineal massage during second stage of labour have demonstrated consistent benefits, including lower rates of episiotomy, reduced incidence of obstetric anal sphincter injuries.