REPLAY: EBB 218 - The Evidence on Perineal Massage during Labor 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

🗓️ 29 October 2025

⏱️ 40 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Can perineal massage during the pushing phase of labor really prevent tears? In this episode, Dr. Rebecca Dekker takes a close look at the research to uncover whether this technique truly helps reduce perineal trauma during childbirth.

She explains how health care staff provide perineal massage during labor, breaks down findings findings from key studies and meta-analyses, and examines how biases and variations in clinical practice shape the evidence. Dr. Dekker also explores why results from settings with high episiotomy rates may not apply everywhere and why skilled, supportive care and informed consent often play a bigger role in protecting the perineum than any single technique.

Content Warning: Discussion of perineal tears during childbirth, severe tears, obstetric violence, and episiotomy.

Resources

For a full list of resources, visit: ebbirth.com/218
Watch the video version here on our YouTube channel which includes study breakdowns and PowerPoint slides.
Protecting the Perineum Series:

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 perineal massage during the pushing phase
0:06.2	and whether it's effective at preventing perineal tears during childbirth.
0:14.2	Welcome to the evidence-based birth podcast. My name is Rebecca Decker and I'm a nurse with my PhD and the founder of evidence-based birth.
0:22.8	Join me each week as we work together to get evidence-based information into the hands of families
0:28.1	and professionals around the world. As a reminder, this information is not medical advice.
0:34.2	See eBbirth.com slash disclaimer for more details.
0:39.9	Hi everyone and welcome to today's episode of the evidence-based birth podcast. My name is
0:45.8	Dr. Rebecca Decker, pronouns she, her, and I will be your teacher for today's episode.
0:51.2	Today I'm so excited to bring to you some evidence-based information about perineal tears
0:56.0	and some research on a method that is sometimes used to prevent perineal tears, and that is
1:01.9	perineal massage during the pushing phase of labor. Before we get started, I want to let you know
1:07.5	up front that we will be talking about some topics, including tears
1:11.3	of the vagina, severe tears from the vagina to the rectum, obstetric violence and traumatic childbirth,
1:18.1	and episiotomies. So today's episode is the fourth in a series that we're doing this year
1:24.3	called Protecting the Perineum. In the first episode, which was Episode 206 of the EBB podcast,
1:31.4	I talked with you about what are perineal tears?
1:34.2	What are the factors that increase your risk of having a paroneal tear during childbirth?
1:38.4	What are the health consequences of experiencing a tear?
1:41.7	And why it's so important to avoid an episiotomy.
1:45.2	And in the second episode, which is episode 210, I talked about warm compresses,
1:50.5	the hands-on technique, and the hands-off technique for preventing tears.
1:55.1	In the third episode, which was episode 216, I talked about the practice of perineal massage
	...

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