REPLAY: EBB 216 - The Evidence on Prenatal Perineal Massage for Preventing Tears in Childbirth with Dr. Rebecca Dekker

Evidence Based Birth®

Rebecca Dekker

Pregnancy, Health & Fitness, Childbirth, Parenting, Birth, Medicine, Kids & Family, Doula, Obstetrician, Midwife

4.6 • 978 Ratings

🗓️ 30 July 2025

⏱️ 42 minutes

🔗️ Recording | iTunes | RSS

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Summary

Curious if prenatal perineal massage actually works to prevent tears during childbirth? In this episode, Dr. Rebecca Dekker examines the evidence on perineal massage in late pregnancy, separating fact from fiction and sharing what the research really shows. You’ll learn what major studies say about perineal massage, why some commonly cited research may not be trustworthy, and whether this practice is truly necessary, especially if you’re in a birth setting with low episiotomy rates. You’ll also hear some surprising insights on other ways to protect your perineum and reduce your risk of severe tears.

Content note: Discussion of perineal tears during childbirth, severe tears, and episiotomy.

(06:14) Evaluating Perineal Massage Evidence

(08:32) Comprehensive Perineal Massage Meta-Analysis

(11:20) Perineal Massage Study Bias Concerns

(16:04) Double-Blind Study on Episiotomy Rates

(20:09) Perineal Massage vs. Control Outcomes

(24:44) Study Bias and Participant Dropouts

(28:11) Research Fraud: Doubts on Dönmez Study

(33:53) Trial Bias in Perineal Massage Study

(35:57) Perineal Massage Study Bias Concerns

(40:43) Effectiveness of the EPI-NO® Device

Resources

For a full list of scientific references, see the blog post that goes along with this episode: https://ebbirth.com/216
Check out Episode 206 of the EBB Podcast to learn about Perineal Tears and Avoiding Episiotomy and Episode 210 to learn about warm compresses and hands on vs. hands off techniques.
Learn more about the Evidence Based Birth® Childbirth Class: https://ebbirth.com/childbirth-class
Take a continuing education class on this topic (and earn a contact hour) by joining the EBB Professional Membership here: https://ebbirth.com/membership
Check open access journals to see if they are on beallslist.net (https://beallslist.net/standalone-journals/) as a potential predatory journal.
Resource for authors to determine whether they should submit to an open access journal: https://thinkchecksubmit.org/

For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional Membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

Transcript

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0:00.0	Hi everyone on today's podcast, we're going to talk about the evidence on prenatal
0:05.2	perennial massage and whether or not it's effective at preventing perennial tears during childbirth.
0:14.6	Welcome to the evidence-based birth podcast. My name is Rebecca Decker and I'm a nurse with my
0:19.8	PhD and the founder of evidence-based
0:22.2	birth.
0:23.4	Join me each week as we work together to get evidence-based information into the hands of families
0:28.8	and professionals around the world.
0:31.3	As a reminder, this information is not medical advice.
0:34.7	See eBbirth.com slash disclaimer for more details.
0:40.2	Hi, everyone, and welcome to today's episode of the evidence-based birth podcast. My name is
0:46.5	Dr. Rebecca Decker, pronouns she, her, and I will be your teacher for today's episode.
0:51.8	Today, I'm so excited to bring you more evidence-based information to you about
0:56.2	perineal tears and some research on a method that is sometimes used with the intent of
1:01.6	preventing perineal tears, and that is perineal massage during pregnancy.
1:06.5	Before we get started, I wanted to let you know that we will be talking about some topics,
1:10.3	including tears, severe tears from the vagina to the rectum, obstetric violence, and
1:15.4	episiotomies.
1:16.4	Also, you might be listening to this episode on a podcasting app, but I also wanted to let
1:21.5	you know that there is a video of this episode on our YouTube channel at Evidence-based
1:25.6	birth.
1:26.6	So if you're more of a visual learner, I encourage you to visit and subscribe to the
1:30.7	EBB YouTube channel today.
	...

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