Clinical trial NCT06935643: The Effect of Birth Ball and Perineal Massage on Perineal Pain, Perineal Trauma and Birth Satisfaction
Official title: The Effect of Birth Ball and Perineal Massage on Perineal Pain, Perineal Trauma and Birth Satisfaction During the Intrapartum Period
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Perineal Pain
Birth Satisfaction
Perineal Laceration, Tear, or Rupture During Delivery
Keywords: Birth Satisfaction
Perineal trauma
Birth Ball
The Effect of perineal massage
The Effect of birth ball
Lead sponsor: Istanbul University - Cerrahpasa
Sponsor class: OTHER
First posted: 2025-04-20
Enrollment: 144
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 35
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: In the study with 3 groups, there were perineal massage group, birth ball group and control group.
Primary purpose: TREATMENT

Brief summary: One of the important causes of perineal trauma is perineal tension. By reducing this tension, perineal trauma can be prevented. Perineal trauma is a birth complication that can be prevented with midwifery approaches. The aim of this study was to investigate the effect of birth ball and perineal massage on perineal pain, perineal trauma and labor satisfaction in the intrapartum period.

Detailed description: Perineal trauma is the disruption of perineal integrity that develops in the genital area at birth and occurs spontaneously or as a result of surgical intervention. One of the important causes of perineal trauma is perineal tension. Perineal traumas can be prevented by reducing this tension.Birth ball and perineal massage are recommended approaches to prevent perineal trauma from the active phase. As a result of these approaches, an increase in birth satisfaction, an increase in quality of life, a decrease in perineal pain and continuity of communication between mother and baby are provided.Massage is started by applying a lubricant to the hands and the fingers are placed into the vagina until the first knuckle. The thumb and index fingers are moved in a "U" shape by pressing the rectum and the tension of the perineal muscles is reduced. In the Positive Birth Experience Booklet published by the World Health Organization, it recommends perineal massage in the second stage of labor to facilitate vaginal delivery and reduce perineal trauma. At a high level of evidence, perineal massage is recommended to prevent third and fourth degree perineal trauma. Perineal trauma care is a condition that increases the cost of delivery, and perineal massage reduces the cost of care and provides quality midwifery care.The use of a birth ball in the intrapartum period increases uterine blood flow, relaxes the muscles and thus reduces pain. Its use is recommended because of its effects on the birth process such as completing the engagement of the fetal head, shortening the duration of the latent phase and increasing the comfort of labor. In addition, the movement of the mother on the birth ball increases the flexibility of the perineal muscles and reduces the risk of perineal trauma. The use of a birth ball is recommended in the first and second stages of labor.

Eligibility criteria: Inclusion Criteria:

* Between 18-35 years old
* Active phase
* Multipar
* Singleton pregnancy
* No risky pregnancy
* No complications for vaginal delivery
* Gestational week between 37-42
* The amniotic membrane has not opened
* No perineal scar tissue
* The anterior cephalic position of the fetal head
* Can speak and understand Turkish
* Pregnant women who agreed to participate in the study

Exclusion Criteria:

* Macrosomic fetus (birth weight over 4000 grams according to ultrasound calculation)
* Vaginal infection and/or sexually transmitted disease

Research Termination Criteria

* Cesarean section decision following trauma (due to fetal distress etc.)
* Pregnant women who develop complications during labor (instrumental delivery, etc.)
* Pregnant women who wish to withdraw from work

Primary outcomes:
measure: Perineal Pain Assessment
timeFrame: Cervical dilatation will assses is 4-5 cm, 6-7 cm ve 8-10 cm until delivery. Pain will be evaluated at the 1st and 4th hour after delivery.
measure: Perineal Trauma Assessment
timeFrame: Perineal trauma will be assessed within 1 hour after birth.If the trauma has developed, it is marked as 'developed'; if the trauma has not developed, it is marked as 'not developed'.
measure: Assessing Maternal Satisfaction at Birth
timeFrame: At the 4th hour after birth, maternal satisfaction will be assess.As the total score obtained from the scale increases, the satisfaction levels of mothers regarding the care they receive in the hospital during normal childbirth also increase.
Secondary outcomes:
Other outcomes:
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