Could a simple manual technique performed by a midwife reduce the incidence of episiotomy and perineal lacerations? A non-randomized pilot study

TL;DR

A midwifery technique called perineal myofascial release may reduce perineal trauma and episiotomy during childbirth, according to a pilot study.

Contribution

This pilot study introduces perineal myofascial release as a potential midwifery intervention to reduce perineal trauma and episiotomy.

Findings

Women in the intervention group were six times less likely to have a non-intact perineum.

The intervention group was twice less likely to undergo episiotomy.

No significant differences were found in labor duration or mode of birth.

Abstract

Women experience medical interventions, episiotomy, and perineal lacerations during childbirth, impacting their physical, psychological, and sexual well-being. This study compares the perineal status of prospective women who had the midwifery intervention of perineal myofascial release during childbirth, to a matched retrospective control sample of women who received standard care during childbirth.

A non-randomized pilot study with prospective data collected for 50 women after informed verbal consent was obtained to having the midwifery intervention of perineal myofascial release during childbirth, and the matched retrospective data for the control group of 49 women were collected from a random sample generated from the medical records. Quantitative analyses included descriptive statistics, independent t-tests, regression, and chi-squared analyses. Retrospective trial registration was granted with The Australian New Zealand Clinical Trials Registry ANZTR.

Women were six times (OR=0.15; 95% CI: 0.0–0.37) less likely to have a non-intact perineum and twice (OR=0.44; 95% CI: 0.35–0.56) less likely to have an episiotomy if they were in the intervention group. Chi-squared analysis found no statistically significant differences between groups for normal vaginal birth and instrumental births, excluding cesareans and waterbirth [χ2(1)= -0.37, p=0.542].

This study found perineal myofascial release benefits women by reducing perineal trauma and episiotomy. However, there were no significant differences in the duration of the active pushing stage of labor or mode of birth. This study has shown some promise in obtaining data for a larger, definitive, randomized controlled trial.

The study was registered on the Australian New Zealand Clinical Trials Registry ANZTR.

ID ACTRN12623000807651

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