Combined perineal massage and warm compress compared to massage alone during active second stage of labour in nulliparas: A randomised trial

•Nulliparity increases risk of perineal trauma during vaginal birth.•Perineal massage increases vasodilatation, tissue elasticity and reduces pain.•Warm compress reduces perineal pain at second stage by increasing blood flow.•Perineal massage and warm compress do not reduce perineal injury requiring suturing.•Women are likely to recommend perineal massage and warm compress to a friend.