Minimizing Genital Tract Trauma and Related Pain Following Spontaneous Vaginal Birth

Authors

  • Leah L. Albers CNM, DrPH,

    Corresponding author
      University of New Mexico College of Nursing, Nursing/Pharmacy Building, Room 216, Albuquerque, NM 87131-5688. E-mail: lalbers@salud.unm.edu
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    • 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.

  • Noelle Borders CNM, MSN

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    • Noelle Borders, CNM, MSN, is a staff nurse-midwife with University Midwifery Associates, Department of Obstetrics and Gynecology, School of Medicine at the University of New Mexico Health Sciences Center in Albuquerque, NM.


University of New Mexico College of Nursing, Nursing/Pharmacy Building, Room 216, Albuquerque, NM 87131-5688. E-mail: lalbers@salud.unm.edu

Abstract

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.

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