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The following techniques and care measures are associated with lower rates of obstetric lacerations and related pain following spontaneous vaginal birth: antenatal perineal massage for nulliparous women, upright or lateral positions for birth, avoidance of Valsalva pushing, delayed pushing with epidural analgesia, avoidance of episiotomy, controlled delivery of the baby's head, use of Dexon (U.S. Surgical; Norwalk, CT) or Vicryl (Ethicon, Inc., Somerville, NJ) suture material, the \u201cFleming method\u201d for suturing lacerations, and oral or rectal ibuprofen for perineal pain relief after delivery. Further research is warranted to determine the role of prenatal pelvic floor (Kegel) exercises, general exercise, and body mass index in reducing obstetric trauma, and also the role of pelvic floor and general exercise in pelvic floor recovery after childbirth.<\/jats:p>","DOI":"10.1016\/j.jmwh.2006.12.008","type":"journal-article","created":{"date-parts":[[2007,4,30]],"date-time":"2007-04-30T14:50:04Z","timestamp":1177944604000},"page":"246-253","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Minimizing Genital Tract Trauma and Related Pain Following Spontaneous Vaginal Birth"],"prefix":"10.1111","volume":"52","author":[{"given":"Leah L.","family":"Albers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelle","family":"Borders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,12,24]]},"reference":[{"key":"e_1_2_14_2_2","volume-title":"Births: Final data for 2003. 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