Does antepartum perineal massage reduce intrapartum lacerations?
Yes–to a point. Antepartum perineal massage reduces both the incidence of perineal trauma requiring suturing and the likelihood of episiotomy in women who have never given birth vaginaliy. It reduces the incidence of postpartum perineal pain in women who have given birth vaginally. Perineal massage doesn’t reduce the frequency of first-or second-degree lacerations or third- and fourth-degree perineal trauma. (Strength of recommendation [SOR]: A, systematic review of randomized controlled trials [RCTs].) Clinical commentary Raise the subject, then let the patient decide Perineal massage is relatively easy to describe and do, but its intimate nature can make physicians and patients alike feel uncomfortable, The benefit for primigravid women justifies asking appropriate patients at least an exploratory question or 2 during early and second-trimester visits. A question such as, “How much do you know about the process of having a vaginal delivery?” often prompts inquiries about pain contro
