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Midwifery Care Measures in the Second Stage of Labor and Reduction of Genital Tract Trauma at Birth: A Randomized Trial
Author(s) -
Albers Leah L.,
Sedler Kay D.,
Bedrick Edward J.,
Teaf Dusty,
Peralta Patricia
Publication year - 2005
Publication title -
journal of midwifery and women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1016/j.jmwh.2005.05.012
Subject(s) - genital tract , childbirth , medicine , randomized controlled trial , episiotomy , perineum , obstetrics , sex organ , pregnancy , gynecology , surgery , physiology , biology , genetics
Genital tract trauma after spontaneous vaginal childbirth is common, and evidence‐based prevention measures have not been identified beyond minimizing the use of episiotomy. This study randomized 1211 healthy women in midwifery care at the University of New Mexico teaching hospital to 1 of 3 care measures late in the second stage of labor: 1) warm compresses to the perineal area, 2) massage with lubricant, or 3) no touching of the perineum until crowning of the infant's head. The purpose was to assess whether any of these measures was associated with lower levels of obstetric trauma. After each birth, the clinical midwife recorded demographic, clinical care, and outcome data, including the location and extent of any genital tract trauma. The frequency distribution of genital tract trauma was equal in all three groups. Individual women and their clinicians should decide whether to use these techniques on the basis of maternal comfort and other considerations.