Impact of perineal massage during second-stage labor on episiotomy rates and perineal tears: A randomized controlled trial in a tertiary care hospital, western Maharashtra

The process of child birth is lauded by numerous psychological and physiological stressors which emerges from the beginning of first stage of labour and reaches its maximum at second stage. It is beneficial to minimize those stressful situations by reducing the duration of the climactic phase of labour. Perineal massage stimulates the Ferguson nerve plexus leading to a series of neuroendocrine response which induces oxytocin production. It also contributes to greater elasticity and softness of perineal muscles owing to reduction in the rate of episiotomy and perineal trauma and ensures the maximum joy and comfort in the postnatal period. Objective: This study aims to evaluate the effectiveness of perineal massage during the second stage of labour on requirement of episiotomy and incidence of perineal tear among intra natal womenMethods: A randomized controlled trial was conducted in a tertiary care hospital in Western Maharashtra. Sixty participants were assigned into two blocks: primigravida (30) and multigravida (30). Each block was further divided into experimental and control groups through random allocation. The experimental group received perineal massage during the second stage of labour, while the control group received routine care. Outcome measure was the requirement of episiotomy and incidence of perineal tear among intra natal women. Data were analyzed using t test, F-tests and Chi-square tests.Results: The findings showed that 53.33% of primigravida in the experimental group required an episiotomy compared to 86.67% in the control group (p = 0.03). However, the incidence of perineal tear did not show a statistically significant difference between groups. In multigravida women, perineal massage did not significantly impact the requirement of episiotomy or incidence of perineal tears.Conclusion: Modern obstetric practice favors restricted use of episiotomy only when medically necessary. Perineal massage, warm compresses, and controlled delivery techniques are encouraged to reduce severe perineal trauma.