Leah L. Albers, CNM, DrPH, FACNM, FAAN, is a Professor at the College of Nursing and in the Department of Obstetrics and Gynecology, School of Medicine at the University of New Mexico Health Sciences Center in Albuquerque, NM.
Minimizing Genital Tract Trauma and Related Pain Following Spontaneous Vaginal Birth
Article first published online: 24 DEC 2010
2007 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 52, Issue 3, pages 246–253, May-June 2007
How to Cite
Albers, L. L. and Borders, N. (2007), Minimizing Genital Tract Trauma and Related Pain Following Spontaneous Vaginal Birth. Journal of Midwifery & Womens Health, 52: 246–253. doi: 10.1016/j.jmwh.2006.12.008
- Issue published online: 24 DEC 2010
- Article first published online: 24 DEC 2010
- genital tract trauma;
- labor management;
- midwifery care;
- perineal pain;
- perineal trauma
Genital tract trauma is common following vaginal childbirth, and perineal pain is a frequent symptom reported by new mothers. The following techniques and care measures are associated with lower rates of obstetric lacerations and related pain following spontaneous vaginal birth: antenatal perineal massage for nulliparous women, upright or lateral positions for birth, avoidance of Valsalva pushing, delayed pushing with epidural analgesia, avoidance of episiotomy, controlled delivery of the baby's head, use of Dexon (U.S. Surgical; Norwalk, CT) or Vicryl (Ethicon, Inc., Somerville, NJ) suture material, the “Fleming method” for suturing lacerations, and oral or rectal ibuprofen for perineal pain relief after delivery. Further research is warranted to determine the role of prenatal pelvic floor (Kegel) exercises, general exercise, and body mass index in reducing obstetric trauma, and also the role of pelvic floor and general exercise in pelvic floor recovery after childbirth.