title: Perineal massage in labour and prevention of perineal trauma: randomised controlled trial.
abstract: OBJECTIVE
  To determine the effects of perineal massage in the second stage of labour on perineal outcomes.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  At 36 weeks' gestation, women expecting normal birth of a singleton were asked to join the study. Women became eligible to be randomised in labour if they progressed to full dilatation of the cervix or 8 cm or more if nulliparous or 5 cm or more if multiparous. 1340 were randomised into the trial.
  
  
  METHODS
  Massage and stretching of the perineum during the second stage of labour with a water soluble lubricant.
  
  
  METHODS
  
  
  
  METHODS
  rates of intact perineum, episiotomies, and first, second, third, and fourth degree tears.
  
  
  RESULTS
  pain at three and 10 days postpartum and pain, dyspareunia, resumption of sexual intercourse, and urinary and faecal incontinence and urgency three months postpartum.
  
  
  RESULTS
  Rates of intact perineums, first and second degree tears, and episiotomies were similar in the massage and the control groups. There were fewer third degree tears in the massage group (12 (1.7%) v 23 (3.6%); absolute risk 2.11, relative risk 0.45; 95% confidence interval 0.23 to 0.93, P<0.04), though the trial was underpowered to measure this rarer outcome. Groups did not differ in any of the secondary outcomes at the three assessment points.
  
  
  CONCLUSIONS
  The practice of perineal massage in labour does not increase the likelihood of an intact perineum or reduce the risk of pain, dyspareunia, or urinary and faecal problems.
authors.affiliation: Centre for Research into Nursing and Health Care, University of South Australia and North Western Adelaide Health Service, North Terrace, Adelaide, SA 5000, Australia. georgie.stamp@unisa.edu.au
authors.forename: G
authors.initials: G
authors.lastname: Stamp
authors.forename: G
authors.initials: G
authors.lastname: Kruzins
authors.forename: C
authors.initials: C
authors.lastname: Crowther
mesh_terms: D000328:Adult; D000465:Algorithms; D004841:Episiotomy; D005260:Female; D006801:Humans; D007748:Labor Stage, Second; D008405:Massage; D007744:Obstetric Labor Complications / Q000517:prevention & control*; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D012306:Risk; D017211:Treatment Failure