This is a bit of an odd rant. Usually I find myself ranting about recommendations that aren’t supported by the evidence. This time, I’m ranting because a recommendation is supported by the evidence, and, well, I think I’d rather it wasn’t.
During pregnancy I was pretty freaked out by the idea of tearing or needing an episiotomy. The risk of these is surprisingly high, and unsurprisingly difficult to find statistics for. BabyCentre reports (without references) that about 9 in 10 women tear when giving birth. In 2005, 67% of women giving birth vaginally at the Royal Berkshire Hospital needed stitches, and 16% needed an episiotomy. I was understandably keen to reduce the risk, and every now and then I’d come across a recommendation to try perineal massage (massaging / stretching the perineum in the last weeks of pregnancy). To be honest, I didn’t like the sound of it and was hoping it would turn out to be a crackpot idea. It didn’t sound like something that would actually work, and it wasn’t being advocated very strongly – I had to ask about it myself in my antenatal classes and appointments. But no, it turns out there’s actual evidence that perineal massage once or twice a week in the last month of pregnancy can reduce the risk of episiotomy, and consequently the risk of needing stitches. Yay. Sort of.
Evidence-based rants 