The Effect of Perineal Massage during the Second Stage of Labor on the Episiotomy Rate in Term Nulliparous Pregnant Women: A Randomized Controlled Trial
Kamonwan Sansom¹, Arithat Patkhunpisit¹, Rungruedee Jeerasap¹
Affiliation : ¹ Department of Obstetrics and Gynecology, Khon Kaen Hospital, Khon Kaen, Thailand
Objective: To determine whether perineal massage during the second stage of labor would decrease the episiotomy rate in term nulliparous pregnant women.
Materials and Methods: Term singleton nulliparous pregnant women with a cephalic presentation in the second stage of labor between September 2022 and March 2023 were randomly allocated into two groups, the intervention group and the control group. The intervention group had perineal massage with normal saline solution (NSS) lubricant, while the control group had standard care without perineal massage. The episiotomy rate was evaluated.
Results: Fifty-eight term nulliparous pregnant women were equally and randomly assigned to the intervention and the control group with 29 participants each. The episiotomy rate in the intervention group was significantly lower than the control group at 44.8% versus 89.6% (RR 0.50, 95% CI 0.32 to 0.76, p=0.001). The rate of severe perineal tearing was not significantly different between the groups at 3.5% (one out of 29) versus 6.9% (two out of 29) (p=0.55). The rate of additional tears of the perineal massage group was greater than the control group without being statistically significant at 24.1% (seven out of 29) versus 6.9% (two out of 29) (p=0.37). There was no adverse effect related to perineal massage.
Conclusion: Perineal massage during the second stage of labor in term nulliparous pregnant women significantly decreases the episiotomy rate.
Received 28 January 2025 | Revised 13 September 2025 | Accepted 22 September 2025
DOI: 10.35755/jmedassocthai.2025.10.776-783-02497
Keywords : Perineal massage; Episiotomy; Perineal tear; Nulliparous
