E-ISSN: 2619-9467

Contents    Cover    Publication Date: 15 Dec 2023
Year 2023 - Volume 33 - Issue 4

Open Access

Peer Reviewed

ORIGINAL RESEARCH
292 Viewed538 Downloaded

The Effects of Perineal Massage Performed During Labor on Childbirth Comfort, Perineal Pain, and Trauma in Nulliparous Women: A Quasi-Experimental Study

Full Text PDF  
JCOG. 2023;33(4):210-20
DOI: 10.5336/jcog.2023-99511
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The purpose of this study was to examine the effects of perineal massage performed during labor on childbirth comfort, perineal pain, and genital tract trauma in nulliparous women. Material and Methods: This is a quasi-experimental study with a control group. The sample consisted of a total of 182 pregnant women, including 91 in the experimental group and 91 in the control group. Perineal massage was performed in the experimental group two, four, and four to six times during the latent, active, and transition phases, respectively. The participants in the experimental group continued to receive perineal massage with every push throughout the second stage of labor. Data were collected using the ''Personal Introductory Form'', ''Visual Analog Scale (VAS)'', ''REEDA Scale'' and ''Childbirth Comfort Questionnaire (CCQ)''. Results: There was a statistically significant difference between the groups in terms of labor conditions including duration of the second stage of labor, perineal trauma status, severity of perineal trauma, and episiotomy application status (p<0.05). After perineal massage, the CCQ mean score at the end of the active phase was 30.53±8.78 in the experimental group and 26.83±7.78 in the control group (p<0.05). Additionally, the postpartum VAS mean score was 3.04±2.08 in the experimental group and 5.72±2.64 in the control group (p<0.001). The REEDA mean total score was 3.23±0.53 in the experimental group and 5.50±1.70 in the control group (p<0.001). Conclusion: Perineal massage administered to nulliparous women during labor increased childbirth comfort and decreased perceptions of perineal pain, and it was associated with lower rates of genital tract trauma.
REFERENCES:
  1. Dahlen HG, Homer CS, Cooke M, Upton AM, Nunn R, Brodrick B. Perineal outcomes and maternal comfort related to the application of perineal warm packs in the second stage of labor: a randomized controlled trial. Birth. 2007;34(4):282-90. [Crossref]  [PubMed] 
  2. Labrecque M, Eason E, Marcoux S, Lemieux F, Pinault JJ, Feldman P, et al. Randomized controlled trial of prevention of perineal trauma by perineal massage during pregnancy. Am J Obstet Gynecol. 1999;180(3 Pt 1):593-600. [Crossref]  [PubMed] 
  3. Aasheim V, Nilsen ABV, Reinar LM, Lukasse M. Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database Syst Rev. 2017;6(6):CD006672. [Crossref]  [PubMed]  [PMC] 
  4. Mamuk R, Gençalp NS. Effect of heat application to the perineum in normal vaginal deliveries on perineal integrity and pain. IJHS. 2013;10(2):48-66. [Link] 
  5. Mei-dan E, Walfisch A, Raz I, Levy A, Hallak M. Perineal massage during pregnancy: a prospective controlled trial. Isr Med Assoc J. 2008;10(7):499-502. [PubMed] 
  6. Sayıner FD, Demirci N. Prenatal perineal masajın vaginal doğumlarda etkinliği [Effectiveness of prenatal perineal massage in vaginal delivery]. Florence Nightingale Journal of Nursing. 2007;1560):146-54. [Link] 
  7. Albers LL, Sedler KD, Bedrick EJ, Teaf D, Peralta P. Midwifery care measures in the second stage of labor and reduction of genital tract trauma at birth: a randomized trial. J Midwifery Womens Health. 2005;50(5):365-72. [Crossref]  [PubMed]  [PMC] 
  8. Beckmann MM, Stock OM. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev. 2013;(4):CD005123. [Crossref]  [PubMed] 
  9. Demirel G, Golbasi Z. Effect of perineal massage on the rate of episiotomy and perineal tearing. Int J Gynaecol Obstet. 2015;131(2):183-6. [Crossref]  [PubMed] 
  10. Zare O, Pasha H, Faramarzi M. Effect of perineal massage on the incidence of episiotomy and perineal laceration. Health. 2014;6(1):10-4. [Crossref] 
  11. Beckmann MM, Garrett AJ. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev. 2006;(1):CD005123. Update in: Cochrane Database Syst Rev. 2013;4:CD005123. [Crossref]  [PubMed] 
  12. Shahoei R, Zaheri F, Nasab LH, Ranaei F. The effect of perineal massage during the second stage of birth on nulliparous women perineal: a randomization clinical trial. Electron Physician. 2017;9(10):5588-95. [Crossref]  [PubMed]  [PMC] 
  13. Albers LL. Reducing genital tract trauma at birth: launching a clinical trial in midwifery. J Midwifery Womens Health. 2003;48(2):105-10. [Crossref]  [PubMed] 
  14. Altuntuğ K, Kızılırmak A, Kartal B, Başer M. Vajinal doğumlarda perine travmasının önlenmesinde perine masajının etkisi [The effect of perineal massage in preventing perineal trauma during vajinal delivery]. J Anatolia Nursing and Health Sciences. 2010;13(3):62-5. [Link] 
  15. Dahlen HG, Homer CS, Cooke M, Upton AM, Nunn RA, Brodrick BS. 'Soothing the ring of fire': Australian women's and midwives' experiences of using perineal warm packs in the second stage of labour. Midwifery. 2009;25(2):e39-48. [Crossref]  [PubMed] 
  16. Renfrew MJ, Hannah W, Albers L, Floyd E. Practices that minimize trauma to the genital tract in childbirth: a systematic review of the literature. Birth. 1998;25(3):143-60. [Crossref]  [PubMed] 
  17. Labrecque M, Eason E, Marcoux S. Women's views on the practice of prenatal perineal massage. BJOG. 2001;108(5):499-504. [Crossref]  [PubMed] 
  18. Coşkuner Potur D, Doğan Merih Y, Külek H, Can Gürkan Ö. Doğum Konforu Ölçeği'nin Türkçe geçerlik ve güvenirlik çalışması [The validity and reliability of the Turkish version of the childbirth comfort questionnaire]. J Anatolia Nursing and Health Sciences. 2015;18(4):252-8. [Crossref] 
  19. Karaman ÖE, Yıldız H. Doğum eylemi travay sürecinde hareket serbestliği: nasıl? Ne sağlar? Kadın doğum hemşiresinin rolü nedir? [Freedom of movement during labor: how? What does it provide? What is the role of the obstetrician and gynecolojy nurses]? Turkiye Klinikleri J Nurs Sci. 2018;10(1):78-87. [Crossref] 
  20. Schuiling KD, Sampslelle C, Kolcaba K. Exploring the presence of comfort within the context of childbirth. In: Bryar R, Sinclair M, eds. Theory for Midwifery Practice. 2nd ed. New York: Palgrave Macmillan Publisher; 2011. p.197-212. [Crossref] 
  21. Charles NA, Yount S, Morgan A. Comfort over pain in pregnancy. Pain Manag Nurs. 2016;17(3):197-203. [Crossref]  [PubMed] 
  22. Eti Aslan F. The assessment methods of pain. J Cumhuriyet University School of Nursing. 2002;6(1):9-16. [Link] 
  23. Eti Aslan F. Ameliyat sonrası ağrı değerlendirmesinde görsel kıyaslama ölçeğiyle basit tanımlayıcı ölçeğin duyarlık ve seçiciliği [The sensitivity and selectivity of the visual analog scale and the verbal rating scale in the assessment of postoperative pain]. J Intensive Care Nursing. 2004;8(1):1-6. [Link] 
  24. Cline ME, Herman J, Shaw ER, Morton RD. Standardization of the visual analogue scale. Nurs Res. 1992;41(6):378-80. [Crossref]  [PubMed] 
  25. Davidson N. REEDA: evaluating postpartum healing. J Nurse Midwifery. 1974;19(2):6-8. [PubMed] 
  26. Üstünsöz A. Epizyotomi iyileşmesinde sıcak ve soğuk uygulamaların etkisi [Yüksek lisans tezi]. Ankara: GATA; 1996. [Erişim tarihi: 12 Şubat 2019]. Erişim linki: [Link] 
  27. Moraloglu O, Kansu-Celik H, Tasci Y, Karakaya BK, Yilmaz Y, Cakir E, et al. The influence of different maternal pushing positions on birth outcomes at the second stage of labor in nulliparous women. The Journal of Maternal-Fetal & Neonatal Medicine. 2017;30(2):245-9. [Crossref]  [PubMed] 
  28. Aquino CI, Guida M, Saccone G, Cruz Y, Vitagliano A, Zullo F, Berghella V. Perineal massage during labor: a systematic review and meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med. 2020;33(6):1051-63. [Crossref]  [PubMed] 
  29. Karaçam Z, Ekmen H, Calişir H. The use of perineal massage in the second stage of labor and follow-up of postpartum perineal outcomes. Health Care Women Int. 2012;33(8):697-718. [Crossref]  [PubMed] 
  30. Geranmayeh M, Rezaei Habibabadi Z, Fallahkish B, Farahani MA, Khakbazan Z, Mehran A. Reducing perineal trauma through perineal massage with vaseline in second stage of labor. Arch Gynecol Obstet. 2012;285(1):77-81. [Crossref]  [PubMed] 
  31. Demir S. Doğumun birinci evresinde ebenin uyguladığı perine masajının genital travmaları ve postpartum ağrıyı azaltmadaki rolü [Yüksek lisans tezi]. İzmir: Ege Üniversitesi; 2011. [Erişim tarihi: 12 Şubat 2019]. Erişim linki: [Link] 
  32. Williams A, Herron-Marx S, Knibb R. The prevalence of enduring postnatal perineal morbidity and its relationship to type of birth and birth risk factors. J Clin Nurs. 2007;16(3):549-61. [Crossref]  [PubMed] 
  33. Akhlaghi F, Sabeti Baygi Z, Miri M, Najaf Najafi M. Effect of perineal massage on the rate of episiotomy. J Family Reprod Health. 2019;13(3):160-6. [Crossref]  [PubMed]  [PMC]