The effectiveness of warm perineal compresses during the second stage of labor on perineal trauma and labor pain: A Systematic Review

Abstract

Background: Labor pain and perineal trauma are the most common complications during childbirth and negatively impact a woman’s physical and emotional well-being. The World Health Organization recommends using warm compresses during the second stage of labor to mitigate perineal injuries. This systematic review evaluates the effectiveness of this intervention to guide informed clinical decisions. Methods: Searches were conducted on PubMed, Google Scholar, and ScienceDirect from inception up to the present day (as of July 2023) for randomized and quasi-experimental trials in English, focusing on vaginal births using warm compresses and measuring outcomes related to pain and perineal trauma. The review followed PRISMA guidelines, and biases were assessed with the Cochrane risk-of-bias tools. Results: The search strategy identified a total of 75 articles, of which 13 were included in the review. In most studies, pain scores in the warm group were significantly lower than in the control group. Warm compress intervention was also associated with lower rates of perineal laceration and a higher rate of intact perineum. Results in suturing-required perineal injuries, severity of perineal trauma, or episiotomy were mixed. Conclusion: It is suggested that the application of warm compresses during the second stage of labor has been shown to be an effective method for reducing labor pain and perineal trauma that does not require suturing. Due to the mixed results found, considerations should be made before applying this intervention for the purpose of reducing perineal tears or episiotomies during labor.

Keywords

• warm compresses
• labor stage
• second
• labor pain
• perineal trauma