Comparing the effect of active and expectant managements of the second stage of labor on perineal status

Introduction: Pregnancy and parturition process affects considerably the society’s health. Female genital injuries caused by vaginal parturition are very prevalent. This study aims at comparing active and expectant managements of the second stage of labor on frequency of perineal injuries and using episiotomy, as a solution. Methods: In this quasi-experimental study, a total of ۱۶۰ qualified pregnant women, diagnosed by a qualified physician, were divided into one of two groups, expectant management group (experimental group, n=۸۰) and active management group (control group, n =۸۰). For the experimental group, in the second stage of labor, researcher did not touch the perineum before the baby’s head delivered and just supported the frontal area and urethra. For the control group, the researcher supported perineum using Ritgen Maneuver. Data were analyzed using SPSS ۱۶, T-test, Fisher’s exact test and Chi-Squared test. Results: In the experimental group, women’s perinea were significantly healthier than those of women in the control group (P<۰.۰۰۱) (۳۸.۸% vs. ۱۰%); however, there was not a significant difference between two groups in terms of spontaneous rupture. Need to perform episiotomy in experimental group was ۳۳.۸%; whereas control group members’ need to episiotomy was ۶۶%, which it was a significant difference (P<۰.۰۰۱). Conclusion: The expectant management of the second stage of labor (perineal control with hand-off technqiue) is accompanied with fewer perineal injuries; therefore, it can be used as a safe technique by the birth centers.