I did a small randomised controlled study on the effect of hot packs on the perineum in second stage in terms of pain and trauma. The results follow in the abstract below. This study was printed and presented at the Australian College of Midwives Conference in Melbourne in 1997.
Our unit now routinely uses hot packs and continues to have an unsutured perineum rate of around 70% across the board for vaginal births. We also have an episiotomy rate of less than 5%. Much of this is attributed to hot packs. If you would like further details please contact me.
-Heather Musgrove, registered midwife
Mildura, Australia
hmusgrove@hotmail.com
Abstract: Perineal Preservation and Heat Application During Second Stage of Labour - Randomised Controlled Trial
This study sought to examine the effectiveness of hot packs via a randomised controlled trial in the second stage of labour.
The experimental group received hot packs (n=36) and the control group did not (n=35). There were a total of 71 women in the study. The results show high levels of patient comfort and pain relief from hot packs. This is demonstrated by results such as: 70% of the recipients of hot packs felt the packs relieved pain and 80% said they provided comfort. The midwifery staff involved also supported the women's view that hot packs were beneficial in reducing pain and perineal damage. In the experimental group 70% of the women required no suturing, being either intact (61%) or having a superficial first degree tear (8%). A further 8% had a first degree tear sutured, 22% of this group sustained a second degree tear (17%) or an episiotomy (3%). As compared to the control group with only 54% of women not requiring suturing and a second degree tear rate of 23% and episiotomy rate of 6%, sutured first degree tears were 17%.(i.e. 16% less suturing in the experimental group).
This study, although small, has begun to validate a midwifery practice that until now had only anecdotal support. With this kind of research expanding midwifery's knowledge, such simple non-invasive techniques like hot packs can be practised and further researched by midwives for the benefit of the women they care for.
Reprinted from Midwifery Today E-News (Vol 1 Issue 33, Aug 13, 1999)
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