THE EFFECTIVENESS OF COMBINED PERINEAL MASSAGE AND KEGEL EXERCISES ON THE DEGREE OF PERINEAL LACERATION IN PRIMIGRAVIDA MOTHERS AT PRATAMA S CLINIC, BOJONEGORO

Abstract

Perineal lacerations are a common issue among women giving birth, particularly during vaginal deliveries. Survey data from *Klinik Pratama S* indicates that among the total deliveries recorded, 40% of mothers experienced spontaneous perineal lacerations. Measures to reduce the risk of perineal laceration include preparing the pelvic floor muscles and perineal tissues during pregnancy through a combination of Kegel exercises and perineal massage. This study aimed to compare two methods of perineal management during childbirth: perineal massage combined with Kegel exercises versus perineal massage without Kegel exercises. The study was conducted at *Klinik Pratama S* in Bojonegoro using a static-group comparison pre-experimental design. The study population consisted of primigravida women with a gestational age of ≥36 weeks. The results showed a significant difference between the perineal massage group, the perineal massage with Kegel exercises group, and the control group, with a significance value (p) of 0.001 (p < 0.05). The group combining perineal massage with Kegel exercises proved more effective than the group performing massage without Kegel exercises or the control group p=0.0001. These findings suggest that healthcare professionals can improve the management and quality of midwifery services—specifically by providing comprehensive antenatal care (ANC) and encouraging pregnant women to practice perineal massage and Kegel exercises. Additionally, families and husbands are encouraged to provide support for these practices to help prevent or reduce the severity of perineal lacerations.