Background:  Labor is the process by which the fetus and the placenta leave the uterus. Delivery can occur in two ways, vaginally or by a cesarean delivery. The majority of women who have a vaginal birth will sustain perineal trauma from a spontaneous perineal tear or episiotomy or both.

Aim: This study aims to assess the effectiveness of hands off versus hands on techniques on perineal trauma and perineal pain among parturient mothers in selected hospitals, Kerala.

Methods: The research design adopted in this study was true experimental post test only design. The study was conducted in 3 hospitals at Kerala such as Karothukuzhiyil hospital Pvt, Lakshmi hospital Pvt and Carmal hospital Pvt. Sample size was computed by power analysis based on the previous studies and it would be a total of 90 samples, with 30 parturient mothers in each groups. Simple random sampling technique (Lottery method) was adopted for the selection of parturient mothers into the study. Perineal trauma was assessed by the scale given by Royal College of Obstetrics and Gynaecology (RCOG), 2001, and visual analogue scale (Combined numerical and categorical pain scale) was used to assess the perineal pain of parturient mothers.

Results:  The results showed that, there was extremely significant difference found in perineal trauma and perineal pain of parturient mothers between study group I and study II at  p=0.000 level. The mean scores of study group I was lesser than the mean scores of study group II.

Conclusion: Different perineal techniques and interventions such as hands on technique, hands off technique, perineal massage, warm compresses etc can be widely used by midwives and birth attendants to prevent perineal trauma during labour.  

Key words:  hands off  technique, hands on technique, perineal trauma and perineal pain



US Department of Health and Human Services National Institutes of Health, https://www.nichd.nih.gov.

Margaret Sherburn, Managing perineal trauma after childbirth, BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g6829 (Published 26 November 2014)

Khaled M K Ismail, professor of obstetrics and gynaecology, Managing perineal trauma after childbirth, BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g6829 (Published 26 November 2014)

The Royal College of Midwives, Evidence Based Guidelines for Midwifery-Led Care in Labour ©The Royal College of Midwives 2012, https://www.rcm. org.uk.

Creswell J. W, Hooper V, Kohn M. L. & Atkinson L. J, Perineal Trauma And Childbirth. The Complete Recovery Room Book. (IIIrded). New York: Oxford University Press., 2004, pg no; 28-31

Ingrid J Rowlands and Maggie Redshaw, Mode of birth and women’s psychological and physical wellbeing in the postnatal period, BMC,2012,12:138, DOI: 10.1186/1471-2393-12-138.

McCandlish and Petrocnik.P, www.elsevier.com/midw, Midwifery http://dx.doi.org/10.1016/j.midw.2014.10.004

Georgina Berridgeet, A study on effect of two methods of perineal management, J Res Med Sci. 2011 Aug; 16(8): 1040–46

Aasheim V, Nilsen AB Vika, Lukasse M, Pregnancy and child birth group, Cochrane, Trusted evidence. Informed decisions, Better Health, 7 Dec 2011, http://www.cochrane.org

Polit and Hungler.Sampling design. Nursing Research - Principles and method. Lippincott: 1999. VI edition,279-89

Dr.Suresh. K.Sharma.Types of Research design. Nursing and Statistics.Elsevier, 2011:99-110

Muda SM, 'Maintaining women's perinealintegrity : participatory action research study', PhD thesis, Southern Cross University, Lismore, NSW. Copyright SM Muda, 2014

Journal of Midwifery and Women’s Health,http://www.institute ofmidwifery.org

SussanSaatsaz, RozitaRezaei, Yiong Huak Chan, and Hamid Sharif NiaJ Obstet Gynaecol India. 2014 Dec; 64(6): 425–29

Faribafahami, Zohreh Shokoohi& Mariam Kampour, the effects of perineal management techniques on labour complications. Iranian journal of nursing and midwifery research, 2012, Jan – Feb; 17(1) :52-57.



How to Cite

PINKIE LIZBETH THOMAS, and J. B. “EFFECTIVENESS OF HANDS OFF VERSUS HANDS ON TECHNIQUES ON PERINEAL TRAUMA AND PERINEAL PAIN AMONG PARTURIENT MOTHERS”. Asian Journal of Pharmaceutical and Clinical Research, vol. 9, no. 6, Nov. 2016, pp. 179-83, doi:10.22159/ajpcr.2016.v9i6.14045.



Original Article(s)