The effect of perineal warm application on perineal pain, perineal integrity, and postpartum comfort in the second stage of labor: Randomized clinical trial

Abstract

Background: Protection of perineum and reduction of perineal pain is important in the second stage of labor. Aim: The aim of this study was to determine the effect of perineal warm application on perineal pain, perineal integrity, and postnatal comfort in the second stage of labor. Methods: A single blind randomized and controlled experimental study was conducted with a total of 100 primiparous pregnant women in the warm application (n = 50) and control groups (n = 50). The warm application group was given a damp and warm application to the perineal region during the second stage of labor and only the standard midwifery care was given to the control group. Pregnant Introductory Form was used in the collection of data. Perineal pain level was measured prior to and after the intervention, after delivery, and 2 h from delivery by means of Visual Analogue Scale. In the postpartum period, the perineal condition was evaluated by the midwife with Questionnaire to Determine the Perineal Condition. Two hours from the delivery, Postpartum Comfort Questionnaire was used to determine the comfort level of the women. Results: It was found that there was a decrease in the pain levels of the warm application group compared to pre-intervention pain levels (p < 0.0001). When the warm application and control groups were compared, we found statistically significant differences between the pain levels immediately after the intervention (perineal pain: 8.54 +/- 1.38 vs. 9.56 +/- 0.57, p < 0.0001), after delivery (perineal pain: 2.20 +/- 1.72 vs. 3.64 +/- 2.07, p < 0.0001), and 2 h after delivery (perineal pain: 0.30 +/- 0.78 vs. 0.68 +/- 0.98, p = 0.028). In the study, the intactness of perineum was found to be significantly higher in the warm application group compared to the control group (p = 0.003). The suture need for perinea was significantly higher in the control group than in the warm application group (p = 0.016). In the study, the physical comfort level of the warm application group was found to be significantly higher than the control group (56.06 +/- 4.61 vs. 54.30 +/- 4.73, p = 0.012). Conclusions: In the second stage of labor, it was found that the application of warmth decreases perineal pain, maintains the perineal integrity, and improves postpartum comfort.