Minimizing Genital Tract Trauma and Related Pain Following Spontaneous Vaginal Birth

Leah L. Albers, CNM, DrPH; Noelle Borders, CNM, MSN

Disclosures

J Midwifery Womens Health. 2007;52(3):246-253. 

In This Article

Summary and Future Research Directions

The key concepts as developed in this article are summarized above. These items represent the clinical practices best supported by the available research, and are elements of care most likely to promote women's health and comfort, and cause no harm. Taken together, these strategies acknowledge childbirth as a normal physiologic event, and they underscore the importance of nonintervention for women without complications, and women being partners in their own care, all hallmarks of midwifery practice.[49]

Several factors have not been examined for their potential contribution in preventing genital tract trauma in childbirth, including pelvic floor exercises, general exercise, and body mass index. The role of regular pelvic floor (Kegel) exercises in preventing obstetric trauma has not been a research priority. Although assessment of compliance with a study regimen on this topic would be problematic, it is plausible that improved tone of the pelvic floor may aid in reducing childbirth lacerations. The role of general exercise during pregnancy has not been studied for its effect on genital tract trauma. General exercise (walking, running, swimming, dancing, aerobics, etc.) benefits the entire body, including the pelvic floor, and may increase physical stamina and body awareness when giving birth. Finally, the importance of body mass index and maintaining a healthy weight has not been studied in relation to minimizing childbirth trauma, although women in the United States are heavier than in previous decades and retrospective analyses have indicated that obesity may be associated with greater genital tract trauma in childbirth.[50] Much remains to be learned about minimizing genital tract trauma in vaginal childbirth.

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