Understanding how to read research and the perineal massage are two separate topics, but it was in an article about the perineal massage during labor where I learned how easy it is for someone to misrepresent research information they cite.
I don’t think it was intentional but a result from a lack of understanding research terminology and standards.
So I’m going to discuss the two together. Unfortunately, I can’t find the article I read at about 38 weeks pregnant that I’m going to talk about.
All the details specific to the article I’m going to discuss are going to be off of memory.
I feel comfortable reading research because I had to read a lot of it to get my degree, and my thesis was my own research project I conducted.
What is a Perineal Massage?
This is the first piece to understand. The perineum is the area between the vagina and anus (in men it’s between the scrotum and anus).
A massage of the area is when a woman (or her partner) sticks thumbs or fingers into the vagina, exerts pressure on the walls and does a massaging motion.
For most women, it’s unpleasant and hurts. There are a few who find it pleasurable, even to the point of being turned on.
Speaking from experience, a more apt term for perineal massage is perineal torture. I found it extremely unpleasant, like many other women.
If it hurts, why do it?
Some claim that doing the massage in the few weeks before labor reduces the occurrence of perineal tearing.
The belief is that the massage stretches out the skin of the perineum making it easier for the baby to come out.
During the second trimester of pregnancy, my vagina completely tightened and dried up.
We were concerned it would make labor more difficult. So we decided to give the perineum massage a try near the end of the third trimester.
Doing a quick google search brought up several pages of instructions on how to do it.
But you know what else came up? Articles claiming it is ineffective.
Perineal Massage during Labor
One article I came across discussed the massage being conducted by a medical professional during labor. That was the first time I’d heard it was done during labor. I was intrigued and read more.
The author of the article talked about how she had watched women going through labor when the massage was done. She considered it a horrible sight.
The massage had been done to the point of the perineum becoming swollen and irritated. It just caused further trauma for the women.
She considered a hands-off approach a much better method for a medical practitioner to take during the labor process.
The hands-off approach basically means to stand by to catch Baby. The midwife, nurse, or OB help to gently guide the baby’s head out, but other than that, leave the mom’s vagina alone.
She cited a research article where the hands-off approach was said to be more effective in reducing perineal tears. I decided to read it over. It was just a synopsis, as is most research articles found through a google search.
There is some research that can be found in full for free over the internet, but usually, you have to pay to read a full article. However, for most people’s needs, the synopsis is sufficient.
There were two big problems with the claim the author of the article made about the research. The first is the phrase “not significant”.
The second was in the methodology of the research. There was nothing wrong in the research itself, but its findings and purpose were not what the author had claimed.
The research did find that there was a decrease in perineal tearing using the hands-off approach versus the perineal massage approach during labor.
However, the decrease was found to be not significant. The term not significant means there was a difference, but it was so miniscule it doesn’t matter.
To use example numbers, perineal tearing with a massage might be 31.1% but using the hands-off approach is 31% tearing (again, not real numbers, just an example).
The difference is not great enough to make decisions off of.
So yes, there was a difference in the numbers in the research, but it wasn’t great enough for the hands-off approach to actually be considered better.
The other piece the author of the article didn’t take into consideration was the methodology. The research was conducted as a review of other studies that had been done.
They took individually published research on the hands-off and hands-on approaches and compared them.
The researches stated themselves the problem with doing this was that the measurements were different in each of the studies they compared.
They did the best they could to minimize the effects of the differences on the results, but those efforts could only go so far.
Because of the difference in parameters of each of the studies they were comparing, they considered their results needed to be taken with a huge block of salt.
So if the researchers felt their study couldn’t be fully trusted, why publish it? Most likely to signify that it’s a worthwhile research topic.
Every research article that is published is supposed to have a section that discusses further research that needs to be done.
So for these researchers, they were pointing out that this was something that needed to be looked into more.
They also recommended that the hands-off approach should be taught to midwives and OBs because it is at least as effective, and possibly more effective, than the hands-on approach.
The research was not intended to be taken in the way the author of the original article I read made it sound.
Back to the Perinium, is the Massage worth it?
In my experience, time worked better than the massage. We did the massage during pregnancy and found it loosened things a bit. But I didn’t like it. So we fell out of practice of doing it.
But during the week leading up to labor, I discovered my vagina loosened on its own. When the time was right, my body got itself into a ready state to push out baby.
There was one reason I found that did make the perineal massage worth it. And that is the breathing practice it provides.
If you find the massage hurts, it is a great opportunity to practice the breathing you want to use during labor. That is probably the biggest benefit I got out of it.
In your own pregnancy, have you tried out the perineal massage? Did you find it effective? Are there any research articles you’ve come across you’d like help understanding? Just send it to me, and I can help break it down for you.