Program

Nurse-Midwifery M.S.

Number of Pages

48

Year Approved

2024

First Advisor

Hardy, Paige

Second Reader

Julie Ann Vingers

Abstract

Introduction: Perineal lacerations are a common occurrence during vaginal birth. While there are many proposed methods to protect the perineum from tearing, there is no consensus on the best method to use. The aim of this review is to compare the efficacy of perineal massage versus warm compress in preventing vaginal lacerations greater than the second degree. Methods: Studies were gathered from a variety of databases and filtered through Covidence. The inclusion criteria consisted of research around primipara, multipara, full-term pregnancy, articles within ten years of publication which were available in English language, birth in any setting, second stage perineal massage, and warm compress. Out of 1187 total articles, 18 studies remained. Results: Six articles researched perineal massage; all found decreased laceration rates. However, two articles found that there was a slight increase in second-degree or higher lacerations. Seven articles researched warm compresses–all found that using warm compresses decreases the rate of lacerations. Five articles used a combination of both interventions. Two articles found that perineal massage groups had better outcomes than warm compress groups. Three articles did not find a significant difference between interventions. Discussion: In conclusion, the authors of this review found that warm compresses may reduce the rate and degree of lacerations slightly more than perineal massage. However, overall there is insufficient data to make a strong recommendation due to low level quality of evidence. Both are viable and low cost options to improve perineal integrity, and the decision should be made based on shared decision making with the patient.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis

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