COMPREHENSIVE REVIEW OF LABOR PAIN MANAGEMENT, PERINEAL TEARS, AND EPISIOTOMY COMPLICATIONS: A FOCUS ON PREVENTION AND THE ROLE OF NURSES

Objective: This comprehensive review aimed to assess perineal management strategies during labor and their effectiveness in preventing perineal tears while enhancing maternal well-being.
Methods: A three-part review was conducted, covering labor pain causes and management, perineal tears and episiotomy, and preventive strategies with a focus on warm compresses. Existing literature and studies were synthesized to offer a holistic perspective on perineal management.
Results: Understanding Labor Pain: Labor pain arises from uterine contractions, perineal and cervical stretching, and pelvic pressure. Management options, including pharmacological and nonpharmacological techniques, such as massage, hydrotherapy, and acupuncture, effectively alleviate pain. Perineal Tears and Episiotomy: Perineal tears, including Obstetric Anal Sphincter Injuries (OASIS), are frequently linked to instrumental delivery, prolonged labor, and fetal positioning. Episiotomy, while at times necessary, carries specific indications and potential complications. Preventive Strategies with Warm Compresses: Studies consistently demonstrate the effectiveness of warm compresses applied during the second stage of labor in reducing perineal tears and enhancing perineal integrity, thereby decreasing the need for sutures. Conclusion:
Effective perineal management during labor is essential to ensure maternal well-being and reduce the risk of perineal trauma. Nonpharmacological pain management techniques provide viable options, while perineal tears and episiotomy complications emphasize the importance of preventive strategies. Warm compresses, thoughtfully applied during labor, consistently contribute to maintaining perineal integrity. Nurses play a pivotal role in implementing these strategies, offering holistic care, and ensuring safe and satisfying childbirth experiences.