References

Abbott P, Sapsford R, 2nd ed.. Buckingham: Open University Press; 1998

Andrews V, Thakar R, Sultan AH, Jones PW Evaluation of postpartum perineal pain and dyspareuniaa prospective study. Eur J Obstet Gynecol Reprod Biol. 2008; 137:(2)152-6

London: ACPWH; 2009

Barnes JHarmondsworth: Penguin; 1979

Beake S, Bick D, Weavers A Revising care to meet maternal needs post birth: an overview of the hospital to home postnatal study. Practising Midwife. 2012; 15:(6)10-3

Bick D Postpartum management of the perineum. British Journal of Midwifery. 2009; 17:(9)570-7

Bick DE, MacArthur C, Winter HEdinburgh: Churchill Livingstone; 2002

Birmingham City Council. 2011. http://www.birmingham.gov.uk/census (accessed 18 September 2014)

Bowling A(eds). London: Open University Press; 2008

Buchan P, Nichols J Pain after episiotomy: A comparison of two methods of repair. J R Coll Gen Pract. 1980; 30:(214)297-300

Burns E, Fenwick J, Schmied V, Sheehan A Reflexivity in midwifery research: the insider/outsider debate. Midwifery. 2012; 28:(1)52-60

Calvert S, Fleming V Minimizing postpartum pain: a review of research pertaining to perineal care in childbearing women. J Adv Nurs. 2000; 32:(2)407-15

Carroli G, Mignini L Episiotomy for vaginal birth. Cochrane Database Syst Rev. 2009; (1)

Cater L Nursing Mirror midwifery forum. A little knowledge. Nurs Mirror. 1984; 159:(11)i-viii

Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, Harper A, Hulbert D Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. BJOG. 2011; 118:1-203

Denzin N Whose Cornerville is it anyway?. Journal of Contemporary Ethnography. 1992; 21:120-32

Department for Business, Innovation and Skills. 2011. http://tinyurl.com/obrrbmw (accessed on 16 September 2014)

London: DH; 2007

London: DH; 2010

East CE, Sherburn M, Nagle C, Said J, Forster D Perineal pain following childbirth: prevalence, effects on postnatal recovery and analgesia usage. Midwifery. 2012; 28:(1)93-7

Finch J(eds). London: Routledge and Kegan Paul; 1984

Gerrard J, ten Hove RLondon: RCM/CSP; 2013

Hammersley M, Traianou ALondon: Sage; 2012

Health and Social Care Information Centre. 2014. http://tinyurl.com/k8t5tkb (accessed on 14 September 2014)

Hedayati H, Parsons J, Crowther CA Rectal analgesia for pain from perineal trauma following childbirth. Cochrane Database Syst Rev. 2003; (3)

Holloway I, Wheeler S, 3rd ed.. Chichester: Wiley–Blackwell; 2010

Kennedy H Postnatal drop-ins: the future?'. Practising Midwife. 2009; 12:(4)16-7

Kettle C The Royal College of Midwives: Evidence Based Guidelines for Midwifery Led Care in Labour.London: RCM; 2012

Kettle C, Hills RK, Jones P, Darby L, Gray R, Johanson R Continuous versus interrupted perineal repair with standard or rapidly absorbed sutures after spontaneous vaginal birth: a randomised control trial. Lancet. 2002; 359:(9325)2217-23

Kettle C, Johanson RB Continuous versus interrupted sutures for perineal repair. Cochrane Database Syst Rev. 2000; (2)

Layton S The effect of perineal trauma on women's health. British Journal of Midwifery. 2004; 12:(4)231-5

Liamputtang P, 3rd edn.. Oxford: Oxford University Press; 2009

Litosseliti LLondon: Continuum; 2003

Liu DTY, 4th edn.. Edinburgh: Churchill Livingstone Elsevier; 2007

MacArthur AJ, MacArthur C Incidence, severity, and determinants of perineal pain after vaginal delivery: a prospective cohort study. Am J Obstet Gynecol. 2004; 191:(4)1199-204

Mason L, Glenn S, Walton I, Hughes C Women's reluctance to seek help for stress incontinence during pregnancy and following childbirth. Midwifery. 2001; 17:(3)212-21

McCandlish R1, Bowler U, van Asten H, Berridge G, Winter C, Sames L, Garcia J, Renfrew M, Elbourne D A randomised controlled trial of care of the perineum during second stage of normal labour. Br J Obstet Gynaecol. 1998; 105:(12)1262-72

London: RCOG press; 2006

London: NICE; 2007

NHS Choices. 2013. http://tinyurl.com/34owylr (accessed 18 September 2014)

London: NMC; 2012

O'Malley D, Smith V Altered sexual health after childbirth: part 1. The Practising Midwife. 2013; 16:(1)30-2

Parahoo K, 2nd ed. Basingstoke: Palgrave; 2006

Polit DF, Hungler BP, 5th edn. Philadelphia: Lippincott, Williams and Wilkins; 1995

Polit DF, Beck CT, 6th edn.. Philadelphia: Lippincott, Williams and Wilkins; 2006

London: RCM; 2001

London: RCM; 2012

Scanlon L(Eds). Edinburgh: Churchill Livingstone; 2003

Seidman I, 2nd edn.. London: Teachers college press; 1998

Serrant-Green L We need to talk-the role of interviewing in research. Nurse Researcher RCN. 2005; (3)

Sleep J, Grant A, Garcia J, Elbourne D, Spencer J, Chalmers I West Berkshire perineal management trial. Br Med J (Clin Res Ed). 1984; 289:(6445)587-90

Steen M Perineal tears and episiotomy: how do wounds heal?. British Journal of Midwifery. 2007; 15:(5)273-80

Sultan AH, Kamm MA, Hudson CN, Thomas JM, Bartram CI Anal-sphincter disruption during vaginal delivery. N Engl J Med. 1993; 29:(26)1905-11

Thacker SB, Banta HD Benefits and risks of episiotomy: an interpretative review of the English language literature 1860-1980. Obstet Gynecol Surv. 1983; 38:(6)322-38

Thompson JF, Roberts CL, Currie M, Ellwood DA Prevalence and persistence of health problems after childbirth: associations with parity and method of birth. Birth. 2002; 29:(2)83-94

Birmingham: WMPI; 2012

Williams A, Herron-Marx S, Hicks C The prevalence of enduring postnatal perineal morbidity and its relationship to perineal trauma. Midwifery. 2007; 23:392-403

Wray J Feeling cooped up after childbirth- the need to go out and about. Practising Midwife. 2011; 14:(2)22-3

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

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).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month