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Systematic review
Perineal warm compress reduces risk of third- and fourth- degree tears and should be part of second stage care
  1. Hannah G Dahlen
  1. School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia
  1. Correspondence to Hannah G Dahlen
    School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW 2751, Australia; h.dahlen{at}

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Implications for practice and research

  • As an effective and acceptable technique, warm compress should be a standard part of second stage perineal care.

  • ‘Hands off’ technique, involving no routine hand manoeuvres to flex the fetal head or guard the perineum, may reduce the incidence of episiotomy.

  • Perineal massage during second stage may reduce severe trauma, however, acceptability to women should be further evaluated.


Early historical records have shown that reducing perineal trauma during childbirth is of interest to both women and health professionals.1 Perineal trauma has been reported to affect around 85% of women giving birth,2 however, not all these women …

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  • Competing interests None.