International Journal of Nursing Research

Objective To evaluate the effectiveness of the free position combined with second stage perineum massage technique in reducing vaginal delivery and episiotomy rates among first-time mothers. Methods A total of 100 primiparas undergoing natural delivery were randomly assigned between January 2025 and July 2025 using a random number table method. The control group (50 cases) received conventional labor care, while the experimental group (50 cases) underwent the free position combined with second stage perineum massage technique. Comparative analyses were conducted on episiotomy rates, labor duration, postpartum hemorrhage, and neonatal Apgar scores. Results The experimental group showed significantly lower episiotomy rates (P <0.05), shorter total labor duration, and reduced postpartum hemorrhage volume compared to the control group (P <0.05). Neonatal Apgar scores in the experimental group (9.81 ± 0.11) were higher than those in the control group (9.27 ± 0.27), with a statistically significant difference (T = 13.0969, P <0.0001). Conclusion The free position combined with second stage perineum massage technique effectively reduces vaginal delivery and episiotomy rates among first-time mothers, demonstrating high clinical value.

Vaginal delivery; Episiotomy rate; Free position; Second stage; Perineum massage technique