Evidence Based Birth® REPLAY: EBB 216 - The Evidence on Prenatal Perineal Massage for Preventing Tears in Childbirth with Dr. Rebecca Dekker
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Jul 30, 2025 Is prenatal perineal massage effective for preventing tears during childbirth? Dr. Rebecca Dekker dives into the evidence, revealing surprising insights and potential biases in major studies. Discover why some commonly referenced research may not hold up, and whether this practice is essential, especially in low episiotomy environments. The conversation also touches on the role of research integrity, highlighting concerns with open access publishing and the risks of unreliable studies. It's an eye-opening exploration of childbirth practices!
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Meta-Analysis Shows Mixed Evidence
- A 2020 meta-analysis combined 11 randomized trials with 3,500 participants on prenatal perineal massage.
- It found reductions in severe tears and episiotomy, but showed publication bias and included questionable studies.
High-Quality Trial in High-Intervention Setting
- The Labriquet et al. 1999 trial was high quality but conducted in a high-episiotomy and high-instrument use Canadian setting.
- Perineal massage benefited first-time birthing people by lowering episiotomy and severe tears but not those with prior births.
Suspect Studies in Predatory Journals
- Two 2015 studies (Ali et al. and Donmez et al.) show suspiciously similar data and flawed methods.
- These studies were likely biased or fraudulent and were published in potentially predatory open access journals.