Promoting normality in the management of the perineum during the second stage of labour

Abstract

The management of the perineum during birth has multiple long term effects on women and their families. The midwife has a key role to play and often midwives vary significantly in the techniques they employ and their justification of these practices.This article seeks to examine current evidence to explore what is known to contribute to lower perineal trauma rates and what practices should be avoided to protect childbearing women. The conclusions drawn may require the updating of practice as well as antenatal education so that woman should be given the information they need to make an informed choice as to what they want for their own body, child and experience. Key PhrasesThe entire focus of midwifery practice is woman-centred care.The midwife as an advocate, involves protecting women from unnecessary intervention which may lead to negative birth experiences. Page 3 of 19Removing pain and factors which interrupt a woman's natural enjoyment of the early postnatal period is vital for the promotion of bonding and breastfeeding and thus overall improved women and child health.Antenatal perineal massage should be advocated by midwives during antenatal care in order to promote women's involvement in their own care and enable them to have a measure of control over what takes place in the second stage of labour.

Beneficios de la sutura continua de la lesión perineal en la adaptación a la maternidad

“…Zaksek et al ( 174) y Kettle et al (175), entre otros, refieren en sus estudios que constituye un factor de riesgo para desarrollar depresión posparto y miedo materno al parto, pudiendo condicionar la futura maternidad, incluso llegando a plantearse la mujer la posibilidad de elección de una cesárea en los partos futuros (176)(177)(178).…”

“…Y en cuanto a la producción de desgarros, no se observaron diferencias en la incidencia (113,177,186).…”

The effect of warm compresses on perineal tear and pain intensity during the second stage of labor: A randomized controlled trial

“…Midwives and nurses use various management techniques of the perineum, which play a significant role in reducing episiotomy and decreasing or minimizing perineal trauma. One of the most common is warm compresses (Moore & Moorhead, 2013 ).…”