Niche Instant Warm Perineal Compress

Description

Feature & Benefits

• Sanitation – Hygienic warm compress.
• Blood flow promotion – Helps to encourage blood circulation in the perineal area before child birth.
• Labour support – Can help labour to progress naturally and minimise the need for surgical intervention or iatrogenic complications.
• Highly recommended – For use within home birth procedures, as increased blood flows to the key area can aid a natural birth at home.
• The best time to use the warm compress is during the second stage of labour. Heat compression, when applied during the second stage of labour, is an inexpensive low-risk treatment that can help reduce perineal trauma.
• Hold the Niche Instant Warm Perineal Compress against the perineum during and in between pushes in the second stage.
• Once applied, the gentle pressure will hold it in place, so the whole perineum will then benefit from the warmth of the compress.
• It is normal to feel a stinging and/or burning sensation.

 

Question: ‘How much fluid does the Perineal Warmer hold? We need to be able to report blood loss during child birth.’

Answer: ‘The Niche Perineal Warmer can absorb up to 200ml of fluid per pad.’

What types of perineal tears can occur during childbirth?

During vaginal birth, it is very common to experience a graze or tear of the labia or, more frequently, the perineum, which is the area between your vagina and anus. For most, these tears are minor and heal quickly. 1 st and 2nd degree: tears that involve muscle/skin that may require stitches. 3rd and 4th degree: severe tears which extend to the muscles that control the anus (the anal sphincter), requiring stitches. These are also called ‘Obstetric Anal Sphincter Injuries’ (OASI).

Am I at risk of a severe tear?

Severe tears (OASI) occur in 3-4 in 100 births. You are at significantly higher risk if:

• Forceps are used to help you give birth.
• This is your first vaginal birth

 

The following may also increase your risk:

• Your baby is born in the back-to-back position
• Your baby is over 4kg (9 lbs)
• You are of South Asian ethnicity
• Your baby is born quickly
• You are over 35
• Your baby’s shoulder gets stuck behind the pubic bone (shoulder dystocia)
• Ventouse is used to help you give birth
• The pushing phase of labour takes a long time

 

Comparison Table: Niche Instant Warm Perineal Compress vs. Alternatives

 

 

 

 

Labour Positions Poster

 

 

Specification & Data Sheet (This content has been translated into Arabic and French. While we strive for accuracy, minor errors may exist.)

Instant Warm Perineal Compress Specification (UK Version)

Instant Warm Perineal Compress Specification (French Version)

Instant Warm Perineal Compress Specification (Arabic Version)

Instant Warm Perineal Compress Specification (Spanish Version)

 

Clinical Paper

A Multi-centre Service Evaluation of an Instant Warm Perineal Compress in Intrapartum Care

 

Survey Forms

Perineal Compress Survey Posters

Midwife Survey – Niche Instant Warm Perineal Compress

Patient Survey – Niche Instant Warm Perineal Compress

 

Blog

Warm Perineal Compress: Why NHS Maternity Teams Are Reviewing Their Approach to OASI Prevention

 

What about recovery?

Most women and birthing people who have a severe tear (OASI) repaired recover well, although it can take some time. Occasionally, long-term pain and a difficulty or inability to fully control the bladder, bowels or the passing of wind can occur. This could lead to:

• Feelings of depression, low mood, isolation
• Anxiety about leaving the house and not being able to quickly access a toilet
• Difficulty bonding with baby
• Concerns about leakage while exercising
• Concerns about having sex or giving birth again

If you experience any of the above after birth, contact your doctor or midwife as soon as possible to access specialist care.

 

How can I reduce my risk of a severe tear?

Perineal massage with a natural oil (such as coconut or almond) from 35 weeks pregnant until birth, as illustrated here. Visit this link for more information on how to do this.

 

OASI Care Bundle 2: abbhealthiertogether.cymru.nhs.uk #

Alternative uses for the perineal warmer 

Heat will relax your muscles, increase blood flow to the area and, because your nerves are relaying the feeling of warmth to your brain, will dampen the pain signal.  Warmth increases blood circulation to the area where it is applied. Blood circulation means more oxygen and nutrients to the site, promoting faster healing. For pain from a caesarean section incision, warm compresses will ease the pain around your abdomen and incision.  Backache can be caused by tense muscles or by not using enough support while breastfeeding your baby. A heating pad may relieve the pain. 

What is  a Perineal Massage?

Antenatal perineal massage (APM) or birth canal widening (BCW) is the massage (painless stretching) of a pregnant woman’s perineum – the skin around the opening to the vagina or (‘birth canal’ – when a baby is in this passage), performed anywhere in the 4 to 6 weeks before childbirth. The practice aims to gently mimic the ‘massaging’ action of a baby’s head on the opening to the birth canal prior to birth, without using the baby’s head, doing some of the hard work of labour (birth) before the start of labour, making birth less stressful on baby. The intention is also to attempt to prevent tearing of the perineum during birth, and eliminate the need for an episiotomy during an instrument (forceps and vacuum extraction) delivery, to avoid infection (cellulitis and necrotising fasciitis), helping to keep antibiotics working into the future.

When should you start massaging the perineum and how often? 

Studies show that from around 34 weeks it can be beneficial to begin massaging and ‘preparing’ your perineum. There can be benefits from as little as once or twice a week, but many recommend three to four times a week or even daily. Start by massaging for a minute then build up to around five to ten minutes a day. Ensure you are using nourishing plant oils such as organic sunflower, grapeseed, coconut, almond and olive oil. Alternatively, use soluble water-based lubricants.

When should perineal massage be avoided? 

• Perineal massage should be avoided if you think you may have a vaginal infection 
• You think your waters may have broken 
• Post-Partum if you have had any stitches or tears following birth 
• If anything feels uncomfortable, beyond the usual feeling of stretching tissues, stop and seek advice from your Midwife. Listen to your body and do what feels right. 

 

‘Old wives tales’ to evidence-based care:

Hannah’s interest in perineal care started when she was a student midwife in the UK. She witnessed a labouring woman who, although close to giving birth, seemed scared of letting her baby emerge. The supervising midwife – an older woman, and very experienced – quietly got up and left the room, and returned a few minutes later with a bowl of steaming water. She proceeded to put a cloth in the water, wring it out, and place it gently on the woman’s perineum.

The woman’s face relaxed noticeably, and she gave birth to her baby. When questioned about what was in the water, the senior midwife answered, “just soothing the ring of fire ducky” (taking the stinging out of the birth). The results showed that warm packs reduce the most severe perineal tearing, as well as lowering women’s pain during the birth and the first couple of days afterwards. The study also found urinary incontinence was reduced three months following the birth.

Perineal warm packs are now accepted as an approved technique for use during childbirth thanks to a validated review of approaches to reduce perineal tearing. The report concludes the use of perineal warm packs is associated with decreased occurrence of perineal trauma and is acceptable to both women and midwives.

The best time to use the warm compress is during the second stage of labour, when you are pushing and your baby’s head is descending. This is when the head is descending down from the womb through the cervix and into the birth canal. The ‘ring of fire’ is when the baby’s head is crowning.

 

OASI injury, £80million in costs

Birth trauma inquiry hears £80m annual cost of treating perineal tears

 

 Authoritative External Links

• Royal College of Obstetricians and Gynaecologists (RCOG) – Reducing your risk of perineal tears
• Queensland Health – Maternity and Neonatal Clinical Guideline: Perineal Care
• Evidence-Based Birth – Evidence on Warm Compresses and Hands-On vs. Hands-Off for Protecting the Perineum

 

Clinical Knowledge Hub

Supporting Maternity Teams with Warm Perineal Compresses

The Niche Instant Warm Perineal Compress has been developed to support maternity teams by providing a practical, ready-to-use solution for delivering therapeutic warmth to the perineum during the second stage of labour.

Over the past two years, Niche Healthcare has worked alongside consultant midwives, consultant obstetricians, labour ward coordinators and maternity teams across the UK. During product evaluations, demonstrations and clinical discussions, we have been asked many practical questions about the use of warm perineal compresses, current clinical practice and the implementation of products designed to support perineal care.

This Clinical Knowledge Hub brings together many of those questions, along with evidence-based information, practical guidance and operational considerations to help maternity teams make informed decisions. It is intended to support healthcare professionals, procurement teams and maternity departments reviewing their current approach to warm perineal compresses as part of their wider commitment to improving maternal outcomes and supporting recognised best practice.

Why Are Maternity Teams Reviewing Their Current Processes?

National maternity programmes continue to focus on improving patient safety, reducing avoidable birth trauma and supporting consistent, evidence-based care. Obstetric anal sphincter injuries (OASI), including third- and fourth-degree tears, can have significant physical, emotional and financial consequences for women and healthcare organisations alike.

Warm perineal compresses are recognised within national guidance as one intervention that may support perineal protection during the second stage of labour. However, through our discussions with maternity teams, we understand that consistently implementing traditional warm compresses can present practical challenges within busy labour ward environments.

Many clinicians have described difficulties associated with preparing warm water, maintaining an appropriate temperature, sourcing clean flannels or swabs, and applying compresses quickly during rapidly changing clinical situations, particularly where instrumental birth becomes necessary.

The Niche Instant Warm Perineal Compress has been designed to help overcome many of these operational challenges by providing a consistent, ready-to-use, self-heating alternative that requires no external heat source.

What We’ve Learned from Speaking with NHS Maternity Teams

During discussions with NHS maternity services, several common themes have emerged.

Healthcare professionals have told us that:

• Maintaining consistently warm compresses throughout labour can be challenging.
• Traditional preparation methods vary significantly between hospitals.
• Some departments use hot flasks, whilst others rely on mixer taps, warmed swabs or flannels.
• Preparing warm compresses can increase workload during busy labour ward activity.
• Instrumental deliveries can leave very little time to prepare traditional warm compresses before application.
• Community midwives would benefit from a portable solution that does not rely on access to heated water.
• Many maternity units are looking for ways to improve consistency, efficiency and standardisation within existing clinical pathways.

These discussions have played an important role in the continued development of the Niche Instant Warm Perineal Compress and the educational resources we provide to maternity teams. The observations above reflect practical feedback gathered during discussions with NHS clinicians and are not intended to replace local clinical policies or professional judgement.

Clinical Questions from NHS Midwives

How are warm perineal compresses currently applied?

Current practice varies between maternity units. Many departments prepare warm water and apply it using flannels or swabs, while others utilise hot flasks or warmed saline. Local procedures often differ depending on available facilities, staffing levels and individual clinician preference.

Why are hospitals considering self-heating warm compresses?

Many maternity teams have highlighted the desire for a more consistent and practical method of applying warmth during the second stage of labour. A ready-to-use self-heating compress removes the need to prepare hot water, reduces equipment requirements and supports a more standardised approach whilst allowing clinicians to focus on patient care.

Can the Niche Instant Warm Perineal Compress be used as a moist warm compress?

Yes. For clinicians who prefer a moist warm compress, approximately 150 ml of sterile water (or water in accordance with local clinical policy) may be added prior to application. This allows the product to be used as a warm moist compress whilst retaining the convenience of its self-heating design.

Does this replace current clinical practice?

No. The Niche Instant Warm Perineal Compress is designed to support existing maternity practice and should always be used in accordance with local policies, clinical judgement and the manufacturer’s Instructions for Use. It is intended to complement recognised perineal care practices rather than replace them.

Does the product support OASI prevention initiatives?

The product has been developed to support the practical application of warm perineal compresses during the second stage of labour. Warm compresses are recognised within national maternity guidance and systematic reviews as one intervention that may contribute to reducing severe perineal trauma when used as part of wider evidence-based maternity care. The Niche Instant Warm Perineal Compress provides a practical method of delivering this intervention within busy clinical environments.

Is the product suitable for community midwives?

Yes. Because the compress is self-heating and does not require access to hot water or electrical equipment, it is well suited to community maternity services, home births and other settings where traditional preparation methods may be less practical.

How does the product help maternity departments?

The Niche Instant Warm Perineal Compress has been designed to:

• Reduce clinical preparation time.
• Improve workflow efficiency.
• Support consistent warm compress application.
• Eliminate the need for hot water preparation.
• Reduce reliance on flannels and reusable equipment.
• Support infection prevention through a single-use design.
• Enable clinicians to spend more time focusing on direct patient care.

Risk Management & Clinical Considerations

There are currently no known CAS alerts relating specifically to the Niche Instant Warm Perineal Compress.

As with any medical device, the product should be used in accordance with the Instructions for Use and local maternity policies. It is intended to support clinicians in delivering recognised warm perineal compress techniques and should not replace professional judgement or established obstetric practice.

The product has been specifically designed to reduce many of the practical barriers associated with traditional warm compress preparation, including the need to source heated water, prepare flannels and maintain consistent temperatures throughout labour. By providing a ready-to-use solution, it may support greater consistency whilst reducing preparation time during busy maternity care.

Supporting Evidence

Niche Healthcare encourages all clinicians to review the current evidence and national guidance when considering the implementation of warm perineal compresses.

Useful resources include:

• RCOG OASI Care Bundle and OASI2 FAQs.
• Cochrane Reviews relating to warm perineal compresses during labour.
• Published research into women’s experiences of obstetric anal sphincter injuries.
• Local NHS maternity guidance and policies.

 

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For procurement details, bulk purchasing, and further product information, contact our team today on 01274 965089 or check out our website at www.nicheofficesolutions.co.uk / www.nicheofficesolutions.co.uk/niche-nhs

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