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Do women who have encountered vaginal childbirth experience long term incontinence or perineal pain?

02 October 2014
Research
02 October 2014
Volume 22 · Issue 10

Abstract

It has been established that around 85% of women who have had a vaginal birth experience perineal trauma, of which approximately 70% of these will require suturing. In the 2011 UK census, 503 972 vaginal births were recorded and 370 984 women experienced perineal trauma. Women anecdotally reporting their concerns in future pregnancies, led to this research being conducted. A qualitative method was used to determine how women felt physically and emotionally following vaginal childbirth. In total, nine women were selected using convenience and purposive sampling and were interviewed between 3–6 months postnatally. Interviews were taped and transcribed verbatim.

An eight-point multifaceted approach has been designed to improve postnatal health in areas where a deficit had been uncovered. This research demonstrated areas of concern in postnatal health, in particular, incontinence and perineal pain. It has also highlighted areas of care provision that need improvement.

Up to 85% of vaginal births result in perineal trauma, of which 69% require suturing (McCandlish et al, 1998; Liu, 2007). It has been suggested that suturing can increase the risk of dyspareunia (Kettle et al, 2002; Layton, 2004), increase the prevalence of incontinence (both urinary and faecal) (Thompson et al, 2002; Layton, 2004) and exacerbate perineal pain (Kettle and Johanson, 2000; Hedayati et al, 2003). In the Hospital Episodes Maternity Statistics 2012-13 report (Health and Social Care Information Centre, 2014), 503 972 vaginal births were recorded between 2012 and 2013, of which 74% of women experienced significant perineal trauma. However, there still appears to be no long-term monitoring of women's experiences of childbirth trauma and what effect it has on their lives. Furthermore, no professional body appears to take ownership in the care of these women once they have been discharged from midwifery care (Williams et al, 2007).

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Perineal
Suture techniques
Urinary incontinence
Faecal incontinence
Episiotomy
Pelvic floor
Postnatal care
Pain
Dyspareunia