Background: Perineal trauma and injury is extremely common during vaginal birth. Nurse-midwives and other obstetric providers should explore the most current literature for possible ways that perineal trauma and injury during vaginal birth can be avoided in patients. Purpose: To determine if hands-on perineum care, given by healthcare providers during labor and delivery, decreases perineal trauma and injury in women giving birth vaginally, compared with as opposed to women delivering vaginally who do not receive any hands-on perineum care. Results: Some hands-on techniques may improve perineal outcomes, but the hands-on techniques vary in effectiveness. The majority of providers currently prefer/use a hands-on technique in at least some situations, and many factors and variables influence perineal outcomes. Conclusions: There is not adequate evidence to support that the majority of hands-on techniques are superior, but there is some evidence that certain hands-on support the techniques can influence perineal integrity outcomes and are potentially superior to allowing an undisturbed physiological birth. The heterogeneity of available studies along with the lack of accounting for other variable factors make it impossible to conclude any significant statistical difference in outcomes between the overall categories of hands-on vs. hands-off perineum support Implications for Research and Practice: Implications include the need to collect more data related to factors that influence perineal outcomes and perineal integrity, as well as to continue to increase obstetric provider awareness.
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Pepple, J. E. (2017). Reducing Perineum Injuries and Trauma During Vaginal Delivery [Masterʼs thesis, Bethel University]. Spark Repository. https://spark.bethel.edu/etd/510