Many expectant mothers have heard about Kegel exercises to strengthen the pelvic-floor muscles before birth, but perineal massage isn't as well-known or recommended as often.
"It's not standard in obstetrics, but there is interest in this area," said Beckmann, an obstetrician with the QE2 Jubilee Hospital in Queensland, Australia.
"It's amazing the number of women who are fearful about cuts and tears and afraid of an episiotomy," said Sally Avenson, a certified nurse midwife in western Washington state.
As more women demand greater control and involvement in their childbirth plan, Avenson said, preventing an episiotomy -- or the spontaneous tears that can occur at childbirth -- has gained mainstream attention, and become a goal for all providers who care for pregnant women.
Perineal massage is now common in some corners of maternal health care, Beckmann said, so "it's nice to see there's some evidence behind it." He now says expecting women should be provided information on perineal massage and its likely benefits.
In the three reviewed studies, women practiced perineal massage for as little a four minutes three to four times a week, and as much as 10 minutes daily, beginning in week 34 of their pregnancy.
Pregnant women may not hear about perineal massage from their obstetrician, but midwives have recommended the practice for years. Avenson, a lecturer with the University of Washington's department of Family and Child Nursing, said it is difficult to separate the effect of perineal massage alone. But she includes the technique in her discussions about "perineal management."
"It goes along with a plan for exercise and nutrition. You can't isolate the perineum from health," s
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Contact: Michael Beckmann
drmikeb@hotmail.com
Center for the Advancement of Health
24-Jan-2006