Mineral Oil Perineal Massage & 2nd Stage Labor

In a previous thread, there was a mention of warm compresses and massage during birth, to help the perineum to stretch (actually, it was more of a question).

I'm looking for some evidence regarding the use of mineral oil, specifically.  I have heard that the use of mineral oil during 2nd stage labor can actually lead to tears; this belief is generated by the understanding that mineral oil is not good for the skin, is drying, etc.  On the other hand, I have heard of midwives who boast of using mineral oil during labor in order to prevent the need for episiotomy.

Is there any evidence for either the effectiveness or anti-effectiveness of mineral oil massage during labor?  Or, as Henci mentioned in the previous thread, is it similar to the main benefit of warm compresses--it helps moms feel good, and therefore allows her to relax and open on her own??

Thanks for any leads and/or insights.

Cindy Unger (Doula & HypnoBirthing instructor)

I am not aware of any studies comparing oils for perineal massage in 2nd stage. The only trial evaluating the effect of techniques for reducing tears did not find a benefit for perineal massage or warm compresses, and women were more likely to ask the midwife to stop perineal massage (13%) compared with warm compresses (2%). A quick search of PubMed using the search terms "perineal massage" and "mineral oil" didn't turn up anything. For what it's worth, though, midwives I have talked to have recommended using vegetable oils such as olive oil.

Albers LL, Sedler KD, Bedrick EJ, et al. Midwifery care measures in the second stage of labor and reduction of genital tract trauma at birth: a randomized trial. J Midwifery Womens Health 2005;50(5):365-72.

-- Henci

I am researching the safety factor for using a petroleum base product on the perineum and the posibiliy of the baby aspirating the oil and causing lung damage.

One of my co-workers stated that at the hospital she previously worked one of the MDs stopped using mineral oil because a baby had lung damage from this.

Do you know of any research that would support  the possible harm to the baby

As I stated in the post prior to yours, I don't know of any research into why one would use one oil over another, but in any case, perineal massage in 2nd stage has not been shown to reduce perineal tears, which would render any debate meaningless.

-- Henci

P.S. I'm trying to imagine how a baby would manage to inhale mineral oil rubbed on the perineum during pushing and not coming up with anything. I don't see how oil could get into its nostrils during crowning, and by the time the baby emerged sufficiently to take a breath, its nose wouldn't be anywhere near the perineum.