• G Stamp, G Kruzins, and C Crowther.
• Centre for Research into Nursing and Health Care, University of South Australia and North Western Adelaide Health Service, North Terrace, Adelaide, SA 5000, Australia. georgie.stamp@unisa.edu.au
• BMJ. 2001 May 26; 322 (7297): 1277-80.

ObjectiveTo determine the effects of perineal massage in the second stage of labour on perineal outcomes.DesignRandomised controlled trial.ParticipantsAt 36 weeks' gestation, women expecting normal birth of a singleton were asked to join the study. Women became eligible to be randomised in labour if they progressed to full dilatation of the cervix or 8 cm or more if nulliparous or 5 cm or more if multiparous. 1340 were randomised into the trial.InterventionMassage and stretching of the perineum during the second stage of labour with a water soluble lubricant.Main Outcome MeasuresPrimary Outcomesrates of intact perineum, episiotomies, and first, second, third, and fourth degree tears.Secondary Outcomespain at three and 10 days postpartum and pain, dyspareunia, resumption of sexual intercourse, and urinary and faecal incontinence and urgency three months postpartum.ResultsRates of intact perineums, first and second degree tears, and episiotomies were similar in the massage and the control groups. There were fewer third degree tears in the massage group (12 (1.7%) v 23 (3.6%); absolute risk 2.11, relative risk 0.45; 95% confidence interval 0.23 to 0.93, P<0.04), though the trial was underpowered to measure this rarer outcome. Groups did not differ in any of the secondary outcomes at the three assessment points.ConclusionsThe practice of perineal massage in labour does not increase the likelihood of an intact perineum or reduce the risk of pain, dyspareunia, or urinary and faecal problems.

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