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Massage for childbirth prep may reduce episiotomy rate

Low-tech, at-home preparation in the last month before childbirth could help pregnant mothers avoid one of the more common surgeries performed on women in the United States, a new review suggests.

The review looked at studies in which women used a massage technique in the last four or five weeks of pregnancy to train the lower genital tract for childbirth. During perineal massage a women kneads the tissue below the vagina to prepare the tissue to expand more easily during birth.

There was a 15 percent reduction in episiotomies among the women who practiced perineal massage the review found, based on results from three trials, including data from 2,434 women.

The findings appear in the most recent issue of The Cochrane Library, publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Lead reviewer Dr. Michael Beckmann and his colleagues also discovered an added benefit: Three months after birth, women who had practiced massage were less likely to report perineal pain -- whether or not they had an episiotomy.

Those positive results were most clear for mothers having their first vaginal birth. But Beckmann said the statistical trend of the research suggests that the benefits would also hold true for the other, smaller sub-groups of women in the study -- given larger sample sizes, more time and research.

An episiotomy is performed in up to 35 percent of vaginal births in the United States each year, affecting as many as 1 million women. But Beckmann said the number of episiotomies performed around the world is dropping following a general shift toward reserving the surgical procedure for emergencies.

A May 2005 article in the Journal of the American Medical Association cast doubt on many of the rationales of
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Contact: Michael Beckmann
drmikeb@hotmail.com
Center for the Advancement of Health
24-Jan-2006


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