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

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).