Review of effective methods to reduce damage to the perineum during delivery and its recovery

Episiotomy means cutting the muscles of perineum during the second stage of labor to widen pelvic outlet and speed up the withdrawal of the fetal head; it is the most common surgical incision in midwifery. Today، a variety of non-pharmacological methods during pregnancy and labor are used to reduce need for episiotomy and after delivery for pain reduction and early recovery. This study was performed with aim to review some of these approaches. In this study، all clinical trials which have been conducted to reduce the need for episiotomy and quick recovery and pain reduction after that until 2014 were used. To obtain the necessary information، the databases of PubMed، Sciencedirect، googlescholar، SID and Iranmedex were used. A total of 20 studies were evaluated based on the Jadad criteria and among them، there were 17 Iranian paper and 3 English articles. The results showed that the majority of methods used during pregnancy and childbirth for reducing the need to episiotomy (perineal massage، Kegel exercises، etc.)، as well as medicinal plants (Aloe vera، turmeric، lavender، marigold، pineapple، chamomile، etc.) used after episiotomy for wound healing and reducing pain are effective، but generally، further studies are needed for better understanding of these plants and their possible complications. In general، most of the methods used to reduce the need for episiotomy and improve healing are effective، but more studies should be performed for better understanding of their possible complications.