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	Perineal massage: Your how-to guide
		Women in the experimental groups were requested to perform a 10 minute perineal massage daily from the 34th or 35th week of pregnancy until delivery.
		Among participants without a previous vaginal birth, 24.3 percent (100/411) from the perineal massage group and 15.1 percent (63/417) from the control group were delivered vaginally with an intact perineum, for a 9.2 percent absolute difference.
		The authors concluded that perineal massage is an effective approach to increasing the chance of delivery with an intact perineum for women with a first vaginal delivery, but not for women with a previous vaginal birth.
	parenting.ivillage.com /pregnancy/plabor/0,,46dl,00.html (632 words)

	Perineal massage - Wikipedia, the free encyclopedia
		Perineal massage is the practice of massaging the perineum to make it more flexible in preparation for childbirth.
		The intention is to attempt to prevent tearing of the perineum during birth, and the need for an episiotomy.
		Perineal massage in labour and prevention of perineal trauma: randomised controlled trial.
	en.wikipedia.org /wiki/Perineal_massage (106 words)

	Massage Therapy Massage Bodywork Massage Therapy Schools Massage Therapy Career
		Antenatal perineal massage, usually performed by the mother or her partner during the latter part of pregnancy, is emerging as a safe and proven alternative, reducing perineal tears and decreasing pain, both during birth and after delivery.
		The massage group was given verbal and printed instruction on perineal massage, to be administered three to four times weekly, for four minutes, beginning six weeks before their due date.
		In addition, the team "assessed whether perineal massage increased women's sense of control during labor and delivery and their satisfaction with the experience." Of the 1,524 women in the study, 493 were multiparous (having one or more previous vaginal births), in contrast to Shipman's group of exclusively nulliparous mothers.
	www.massagetherapy.com /articles/index.php/article_id/539 (1959 words)

	London Massage (Site not responding. Last check: 2007-10-20)
		Massage is the practice of applying pressure or vibration to the soft tissues of the body, including muscles, connective tissue, tendons, ligaments, and joints.
		Erotic massage may be utilized as a means of stimulating the libido, or increasing the ability of a person to respond appropriately to sensual stimulus.
		In other cases, erotic massage may be used professionally to desensitize a man to the sensual touch of a woman, such that he may increase his sexual stamina and avoid premature ejaculation.
	www.blownspeakers.com /pages3/53/london-massage.html (1100 words)

	Antenatal perineal massage for reducing perineal trauma
		To assess the effect of antenatal perineal massage on the incidence of perineal trauma at birth and subsequent morbidity.
		Antenatal perineal massage was associated with an overall reduction in the incidence of trauma requiring suturing (three trials, 2417 women, relative risk (RR) 0.91 (95% confidence interval (CI) 0.86 to 0.96), number needed to treat (NNT) 16 (10 to 39)).
		Antenatal perineal massage reduces the likelihood of perineal trauma (mainly episiotomies) and the reporting of ongoing perineal pain and is generally well accepted by women.
	www.cochrane.org /reviews/en/ab005123.html (623 words)

	Perineal Massage
		Perineal massage is the gentle stretching and massaging of the perineum (skin between the anus and vagina) during the last few weeks of pregnancy.
		Second, perineal massage familiarizes the mother with the stretching sensations she will feel as the baby is born.
		Perineal massage can be done by the mother or her partner.
	www.birthingnaturally.net /cn/technique/perineal.html (415 words)

	[No title]
		Perineal massage is a massage technique used to stretch and prepare the skin of the perineum, (the skin between the vagina and anus) for birth.
		Perineal massage not only prepares the perineal tissue for birth but also teaches women how to control these muscles as well as how to relax them not only for birthing purposes but also for general pelvic exams.
		The perineal massage technique consists of the expectant mother or her partner applying pressure by inserting one or two fingers into the vagina and stretching downwards and to the sides of the vaginal entrance.
	www.amcollege.edu /perinealmassage.htm (413 words)

	Perineal Massage in Pregnancy and Labour by Sharon Callcott, massage practitioner
		Perineal massage will also help her to become aware of the pressure sensation that she will feel during delivery and enable her to have confidence that her muscles can distend to facilitate childbirth without ‘ripping from stem to stern'.
		As a massage therapist I want to be able to let the mother have options to choose what feels right for her so I have introduced 2 forms of the massage in the massage guide written instructions.
		I believe the perineal massage in conjunction with pelvic floor exercise is a great way to help a woman get in tune with her body, learn its abilities and have confidence in those abilities to deliver her baby.
	www.btinternet.com /~wellmother/projects/sharoncallcott.htm (3450 words)

	Perineal massage helps childbirth
		Perineal massage is now common in some corners of maternal health care, Beckmann said, so "it's nice to see there's some evidence behind it." He now says expecting women should be provided information on perineal massage and its likely benefits.
		In the three reviewed studies, women practiced perineal massage for as little a four minutes three to four times a week, and as much as 10 minutes daily, beginning in week 34 of their pregnancy.
		Avenson, a lecturer with the University of Washington's department of Family and Child Nursing, said it is difficult to separate the effect of perineal massage alone.
	www.news-medical.net /?id=15593 (760 words)

	Prenatal Perineal Massage
		Perineal massage is a technique used during late pregnancy to increase to possibility of delivering the baby with little or no damage to the tissues in the vaginal area.
		The massage should be done daily for at least five minutes beginning about 4 weeks before the birth of the baby.
		As you massage, pull gently outwards (forwards) on the lower part of the vagina with your thumbs hooked inside.
	www.treeoflifemidwife.com /Client_Information/perinealmassage.htm (421 words)

	The Maternity Center - Episiotomy Article Page (Site not responding. Last check: 2007-10-20)
		Massaging the perineum (skin and tissues around the vaginal opening) daily for the last six weeks of pregnancy may help avoid the need for an episiotomy and/or prevent tearing by stretching the vaginal and perineal tissues.
		The massage should be done daily for 5 to 10 minutes beginning at 34 weeks (six weeks before your due date.) You can do the massage yourself, but many women have found it easier for their partner to do it.
		Massage a natural oil (wheat germ, olive or plain salad oil) into the tissues of the perineum and just inside the vagina.
	www.maternitycenter.com /articles/episio2.html (414 words)

	perineal massage (Site not responding. Last check: 2007-10-20)
		Prenatal perineal massage has been shown effective in preventing the need for episiotomy and a decrease in the amount of...
		Perineal massage is the practice of massaging the perineum to make it more flexible in preparation...
		Perineal massage is the gentle stretching and massaging of the perineum (skin...
	yellowpages-gd.com /articles/47/perineal-massage.html (452 words)

	[No title] (Site not responding. Last check: 2007-10-20)
		Due to society’s differing views of the meaning of massage, it is defined by the medical dictionary, as a method of manipulation of the body by rubbing, pinching, kneading, and tapping.
		Therefore, if perineal massage is effective during pregnancy for the prevention of perineal trauma at birth, then perineal trauma should be less for participants with a 10-minute daily perineal massage, then those who did not receive one.
		It was found that among the participants with out a previous birth, 24.3% from the perineal massage group and 15.1% from the control group were delivered with an intact perineum.
	www.msu.edu /user/pelleti8/essay3.html (582 words)

	Perineal massage in labour does not prevent trauma -- 322 (7297): 0 -- BMJ (Site not responding. Last check: 2007-10-20)
		Perineal massage in labour does not prevent trauma -- 322 (7297): 0 -- BMJ
		Perineal massage in labour does not prevent trauma
		Perineal massage in the second stage of labour has no effect on perineal trauma or pain, or subsequent sexual, urinary or
	bmj.bmjjournals.com /cgi/content/full/322/7297/0/e (116 words)

	American Family Physician: Perineal Massage During Labor Offers Limited Benefit
		Massage and stretching of the perineum during labor have been advocated to prevent perineal trauma, but no scientific trials to determine the effectiveness of massage and stretching have been conducted.
		The authors conclude that perineal massage did not increase the likelihood of delivery with an intact perineum, but a larger study is needed to clarify a potential reduction in third-degree tears.
		Perineal massage in labor and prevention of perineal trauma: randomised controlled trial.
	www.findarticles.com /p/articles/mi_m3225/is_11_64/ai_80813351 (455 words)

	Seasons India :: Perineal Massage
		Massaging this area regularly during the last few months is thought to minimise possible tearing and reduce the need for an episiotomy.
		It is possible to massage this area yourself or with the help of your partner.
		As you massage, keep pulling gently outwards with your thumb inside the lower part of the vagina, stretching the tissue.
	www.seasonsindia.com /pregnancy/perinealmassage_sea.htm (274 words)

	Perineal Massage: Instructions for doing perineal massage and when to start.
		While evidence supports the use of perineal massage as a way to reduce tearing and as an alternative method to performing an episiotomy, exactly how to do it is often confusing.
		Perineal massage should be started at 34 weeks of pregnancy or 6 weeks before your due date.
		Perineal massage can be done by you or your sexual partner, The first few times, take a mirror and look at your perineum so you know what you are doing.
	pregnancychildbirth.suite101.com /article.cfm/perineal_massage (571 words)

	Using Massage to Avoid Episiotomy
		Prenatal perineal massage may reduce the need for episiotomy and the chance of serious tearing at birth.
		Perineal massage should not be done if you have a vaginal infection, a herpes sore, or other vaginal condition that may be spread or worsened by the massage.
		If you wish to use it, the massage should be started sometime in the last trimester, at least 3-4 weeks before the due date, 2-4 times per week or more if you are comfortable.
	www.geocities.com /betterbirths/pmassage.html (691 words)

	Perineal massage in labour fails to prevent perineal damage
		For women in the control group, midwives were instructed to use their usual technique, but to refrain from using perineal massage.
		There were fewer serious (third degree) tears in the massage group, but larger trials are needed to assess whether massage can protect against the risk of this rarer outcome, add the authors.
		Despite these findings, this trial does show that perineal massage is not harmful, and that in itself may be of value, say the authors.
	www.eurekalert.org /pub_releases/2001-05/BMJ-Pmil-2405101.php (267 words)

	Perineal massage may reduce third-degree tears, labor time - Massage Magazine
		"Perineal massage in labour and prevention of perineal trauma" was conducted by Georgina Stamp of the Centre for Research into Nursing and Health Care, at the University of South Australia; Gillian Kruzins of the North Adelaide Women's and Children's Hospital; and Caroline Crowther of the University of Adelaide Department of Obstetrics and Gynecology.
		"Although perineal massage in labor did not increase the likelihood of an intact perineum, our trial does provide good evidence of lack of harm that in itself may be of value," state the authors.
		The trial also provided evidence that perineal massage may reduce the amount of time a woman is in labor.
	www.massagemag.com /Magazine/2002/issue97/research97.php (491 words)

	TreeHugger Mums \| Prenatal Perineal Massage
		First massage a good, natural oil into the area, such as wheatgerm oil, almond oil, vitamin E oil or any non-mineral oil (avoid almond oil if you have nut allergies).
		Massage and lubricate the skin and inner inch or so of the vaginal opening, and the lower vaginal walls.
		As you massage in the oil, feel how stretchy it is. To massage, place both thumbs into your vagina, up to the first joint.
	www.treehuggermums.co.uk /articles/pregnancy/article.php?article=20 (590 words)

	Perineal massage (Site not responding. Last check: 2007-10-20)
		Perineal massage should not be performed if you have a skin lesion without seeking the advice of your doctor or midwife.
		Perineal massage should be comfortable but give a feeling of stretching similar to that which will be experienced when the baby's head presses against the pelvic floor.
		Continue the massage for up to five minutes at a time and repeat it on alternative days.
	www.manbit.com /obstetspain/obnat21.htm (300 words)

	What is perineal massage? - Labor and Birth
		Perineal massage, done during the last month of pregnancy, helps to prepare your perineal tissues for the stretching needed for birth.
		Perineal massage can be done alone, or you can have your partner be your helper.
		If you are going to be doing the massage yourself, the best positions are usually either standing with one foot raised and resting on the bathtub, or chair.
	www.amazingpregnancy.com /pregnancy-articles/403.html (552 words)

	Birth: Preparation: How can I do perineal massage? at Pregnancy & Baby (Site not responding. Last check: 2007-10-20)
		Perineal massage is a technique designed to nourish and condition the tissues of the perineum, the area between the vagina and the rectum.
		The purpose of perineal massage is to increase the possibility of delivering a baby without an episiotomy or a tear.
		Doing the massage helps a woman to identify those muscles and learn to relax them in response to the pressure of her baby's head when he is being born.
	pregnancyandbaby.com /inside/look/387.htm (670 words)

	Strategies for an Easier Labour
		While studies are not conclusive about the value of perineal massage, some research suggests it reduces a woman’s chance of tearing when she pushes her baby into the world.
		The area to be massaged is the lower half of the vagina, from three o’clock to nine o’clock.
		Another benefit of perineal massage is that it helps women learn to consciously relax the perineum, allowing for an easier passage of the baby.
	www.todaysparent.com /pregnancybirth/labour/article.jsp?content=20051220_150203_4452&page=3 (612 words)

	When Should I Have an Episiotomy? - iVillage
		Midwives have studied the practice of perineal massage and have found some benefit to its use if it's done on a regular basis during the last four to six weeks of pregnancy.
		Massage of the perineum is not recommended if you have a history of preterm labor or have given birth to a preterm infant.
		Delay massage if you have an active herpes outbreak anywhere on your body, any lesions present on the genitalia or any indications that you have a vaginal infection.
	parenting.ivillage.com /pregnancy/plabor/0,,midwife_8rrbhhff-4,00.html (230 words)

	Perineal massage in labour and prevention of perineal trauma: randomised controlled trial -- Stamp et al. 322 (7297): ...
		Perineal trauma during and after childbirth is associated with short and long term morbidity for women.
		trials of perineal massage in the second stage of labour was highlighted.
		perineal massage in labour, 81 (43%) of 189 midwives were undecided
	bmj.bmjjournals.com /cgi/content/full/322/7297/1277 (2710 words)

	OB/GYN News: Some Techniques May Help Reduce Perineal Trauma - Perineal Massage, Warm Compresses
		Judicious use of anesthesia could reduce perineal trauma by increasing the woman's active participation in labor and helping to avoid the lithotomy position and use of stirrups, which have been associated with increased trauma, Ms.
		Hands-on approaches include prenatal perineal massage by the woman or her partner during the last 4-6 weeks of pregnancy to increase perineal elasticity.
		Three recent studies found an association between prenatal perineal massage and reduced lacerations in nulliparous women, with a 6% increase in intact perinea in one study and a 9% increase in another, she said.
	www.findarticles.com /p/articles/mi_m0CYD/is_20_36/ai_80744168 (666 words)

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