The effectiveness of prenatal perineal massage at reducing the risk of perineal trauma during vaginal delivery: a meta-analysis

Background: Perineal injury occurs in 85% of all women who experience a vaginal delivery.1 Research has suggested that prenatal perineal massage can reduce the risk of perineal trauma. The purpose of this meta-analysis is to determine if perineal massage should be performed in pregnant women as preparation for their vaginal delivery. Methods: Electronic databases were searched and eligible articles involving prenatal perineal massage compared to standard routine care during pregnancy were gathered. The PEDro Scale was used to assess the quality of the studies included in this meta-analysis. Data including sample sizes were extracted to calculate the overall relative risk of an episiotomy or laceration occurring in the perineal massage group over the control group. Results: After screening, 7 controlled trials were included for analysis. Women were found to have a 30% risk reduction of experiencing a third- or fourth-degree tear after practicing perineal massage. Static massage decreased the risk of third- and fourth-degree tears by 73% and dynamic massage by 16%. Perineal massage 3-4 times per week decreased the risk of third- and fourth-degree tears by 73% compared to 22% for daily massage. Conclusion: Digital perineal massage reduced the severity of perineal injury. Future research should be conducted to determine the most effective parameters and techniques for perineal massage.