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Women's perceptions of perineal repair as an aspect of normal childbirth

02 August 2015
Volume 23 · Issue 8


Aims and objectives:

The purpose of the study was to explore women's perceptions of perineal repair as an aspect of normal childbirth.


The study design was qualitative and used interpretive phenomenology.


11 nulliparous women were recruited. Of these, 10 sustained a 2nd degree tear and one had a posterior vaginal wall tear. All care was undertaken by midwives.


Women accept perineal repair when it is managed correctly, their satisfaction is improved when they are given relevant information. Women place as much significance on the lead up antenatally and their recovery afterwards as they do to physically being sutured.


Antenatal services fail to adequately inform about perineal repair and women's preconceptions are affected by their peers. The transition to motherhood for women who feel fully informed is smoother. Women with unresolved questions about their repair, tend complain of increased pain, make unnecessary alterations to everyday hygiene tasks and rely more on their partners.

In the UK 85% of vaginal deliveries will result in a woman sustaining some degree of perineal trauma, of which two thirds will require suturing (Bick et al, 2010). Simple perineal trauma is classified as; a first degree tear, where there is only damage to the perineal skin, or a second degree tear, which involves trauma to the skin and perineal muscle (Fernando and Sultan, 2004). More complex tears, which are usually repaired by a senior obstetrician are defined as a third or fourth degree tear. As midwives are the lead professional at the majority of births, they are the practitioners who undertake the crucial role of perineal assessment post birth.

Midwives in the UK who have received sufficient training are expected to carry out the repair of first or second degree tears, and episiotomies (Tohill and Kettle, 2013). The aim of perineal repair is to achieve haemostasis and prevent infection, assist with wound approximation and to promote healing by primary intention. It is important that wherever possible, midwives undertake perineal repair as it maintains continuity of care, which has been found to make the experience less stressful for women (Royal College of Midwives (RCM), 2012).

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