• The effect of active and passive pelvic floor muscle preparation technique on pain and rate of episiotomy during delivery: A systematic review
  • Nahid Javadifar,1 Atefeh Rahmani,2,* Ayda Ahmadibeni,3
    1. Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
    2. USERN office, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran / Student Research Committee, School of Rehabilitation, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
    3. Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran /USERN office, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran


  • Introduction: Pelvic floor muscle pain and episiotomy during childbirth is very common during delivery, especially among primiparous women. It is frequently observed during delivery and can have detrimental effects on a mother’s health and quality of life. Having prepared pelvic floor muscle can reduce these negative effects. Pelvic floor muscle preparation techniques can be divided into active and passive. Active techniques need patients voluntary contractions like pelvic floor muscle exercises, while passive techniques are applied by therapist and the patients muscles do not engage voluntarily like perineal massage. The aim of this study is evaluating the effect of active and passive pelvic floor muscle preparation technique on pain and rate of episiotomy during delivery.
  • Methods: The present study is based on articles extracted from Web of Science, Pubmed and Scopus databases and Google scholar search engine. Initially, 140 articles related to the keywords Pelvic floor muscle exercise, Antenatal perineal massage, perineal tearing, Pregnancy, Physiotherapy and Episiotomy were found during the years 2013 to 2022. Then, with further reviews, 17 completely related articles based on the PRISMA checklist were selected for review.
  • Results: 11 articles reviewed the passive technique. 2 of them considered the effect of these techniques in the process of reducing pain during childbirth ineffective, and the remaining 9 indicated the positive effect of these methods on reducing pain. It should be noted that all 11 articles expressed the positive effect of passive technique on reducing the rate of episiotomy. 6 other papers reviewed active techniques, all of which reported reduced pain and the rate of episiotomy during delivery.
  • Conclusion: According to the articles reviewed in this study, it seems that active and passive preparation technique reduces pelvic floor muscle pain and rate of episiotomy during delivery. More research are needed to compare the effectiveness of active and passive techniques.
  • Keywords: Pelvic floor muscle pain, Labor phase, Active and Passive pelvic preparation technique