REPLAY: EBB 210 - Evidence on Warm Compresses and Hands-on vs. Hands-off for Protecting the Perineum
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Jun 11, 2025
Discover evidence-based strategies to prevent perineal tears during childbirth. Learn how warm compresses can lower the risk of severe tears and ease pain. Explore the debate between hands-on and hands-off techniques used by providers, and find out which method truly offers the best protection for your perineum. This informative discussion sheds light on practical approaches for expecting families and healthcare professionals, highlighting the importance of informed choices in maternal care.
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Warm Compresses Reduce Severe Tears
Warm compresses during childbirth significantly reduce severe perineal tears and episiotomy rates.
They also improve maternal comfort by lowering pain and urinary incontinence postpartum.
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Offer Warm Compresses Routinely
Warm compresses should be routinely offered to birthing people for comfort and to reduce severe tears.
This low-cost method has no risks and many potential benefits in all birth settings.
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Hands-Off Might Protect Perineum More
Hands-off technique may be more protective by allowing gradual perineal extension without pressure.
It prevents perineal ischemia, which may reduce severe tears.
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Curious how to actually prevent perineal tears during childbirth? In this episode, Dr. Rebecca Dekker breaks down the latest research on three of the most talked-about methods: 1) using warm compresses, 2) provider “hands on” techniques, 3) provider “hands off” techniques, and how these approaches measure up when it comes to protecting your perineum. You’ll learn surprising facts, like how a simple warm washcloth can significantly lower your risk of severe tears (and even ease pain!), plus what the evidence really says about whether a provider should help “guard” the perineum or just keep their hands off you during the actual birth. Content note: Discussion of perineal tears during childbirth, severe tears, and episiotomy. (02:55) What is the Perineum? (05:33) Warm Compresses Reduce Birth Tears (08:51) Warm Compresses Reduce Birth Complications (12:27) Hands On vs. Hands Off (18:07) Hands-On vs. Hands-Off Perineal Techniques (19:38) Perineal Support Training Reduces Tearing (22:47) Hands-On vs. Hands-Off Birth Resources
For a full list of scientific references, visit the EBB website here.
To watch the EBB YouTube video with visual props, visit here.
Listen to Episode 206 of the EBB Podcast (Perineal Tears and Avoiding Episiotomy) here.
Evidence Based Birth® 