Background and Objectives: This retrospective analysis investigated the impact of preparation of the pelvic floor for childbirth with stretching balloons and perineal massage on the risk of pelvic floor injuries. Materials and Methods: We analyzed 150 primiparous women who accessed private clinics in Padua (Italy) in the period 2019–2023 regarding the rate of perineal trauma and postpartum dysfunction across three groups: the balloon stretching group (BSG, N = 50, 33.3%), the perineal massage group (PMG, N = 39, 26.0%), and the control group (CG, 61, 40.7%). Results: Prenatal perineal training had a significant impact on reducing the rate of perineal injury and episiotomy (27.5% in BSG vs. 48.7% in PMG and 68.3% in CG, p = 0.008, respectively, 9.8% vs. 26% and 40%, p = 0.046) and the duration of the second stage of labor (BSG and PMG had a shorter duration compared to CG with a mean difference of −0.97892 h, p < 0.001, respectively, −0.63372 h, p = 0.002). Patients who carry out the preparation with the stretching balloon are less likely to develop urinary and anal incontinence and pain during intercourse. Specifically, the rate of urinary incontinence in BSG stands at around 23.5% compared to 43.6% in PMG (p = 0.345) and 55% in CG (p = 0.034). Dyspareunia in BSG was detected in 11.8% of cases compared to 35.5% in PMG (p = 0.035) and 61.7% in CG (p < 0.01). Symptomatology inherent to the posterior compartment was reported in 9.8% of cases in BSG vs. 23.11% in PMG (p = 0.085) and 33.3% in CG (p = 0.03%). Conclusions: Stretching balloons and perineal massage can be chosen as tools to prevent and reduce the rates of obstetric trauma during childbirth and to reduce the use of episiotomies as well as protect against the development of dysfunctions of the pelvic floor.

Background/Objectives: Perineal injuries, including episiotomies and spontaneous tears, are common complications during childbirth, often leading to significant discomfort and prolonged recovery for women. This retrospective observational cohort study aimed to explore the relationship between antenatal anovaginal distance (AVD) and the incidence of perineal injuries in a cohort of pregnant women evaluated for pelvic floor health at 28 to 32 weeks of gestation. Methods: Conducted at the University Hospital of Padua over 18 months, the study included 416 women who underwent vaginal delivery at term. Based on AVD, the study participants were divided into two groups: AVD-N group, which included 252 patients with AVD ≥ 2 cm, and the AVD-R group, which included 164 with AVD < 2 cm. The results of the pelvic floor assessment and those related to childbirth were then examined in relation to AVD (reduced vs. normal). Results: The study found that women with reduced AVD were more likely to experience perineal injuries. Specifically, the incidence of episiotomy and severe perineal tears (3rd and 4th degree) was significantly higher in the reduced AVD group (p < 0.05). Furthermore, a lower AVD was associated with increased perineal muscle hypertonicity and a higher likelihood of operative delivery with episiotomy. Logistic regression analysis confirmed that reduced AVD was an independent risk factor for perineal injuries, regardless of other maternal or neonatal characteristics. Conclusions: These results suggest that AVD measurement during pregnancy may help identify women at higher risk of perineal trauma, enabling more personalized obstetric care to mitigate these outcomes.