Alleviating postnatal perineal trauma: to cool or not to cool?

This article discusses the evidence reported from quasi randomised trials and randomised controlled trials on the efficacy and acceptability of localised cooling methods in alleviating perineal trauma. Two types of cooling methods were identified: iced sitz baths and cooling devices. The review suggests that cooling may lower the levels of reported perineal pain after childbirth and reduce the inflammatory response associated with perineal trauma. However, women's preferences as well as the efficacy of the cooling method should be taken into consideration. Women's natural reluctance to sit in iced sitz baths suggests that this cooling method is unpleasant and may explain why there has been a decline in this method being used in clinical practice over the last two decades. The use of localised cooling devices appear to be a more acceptable method for women.