Women’s experiences of perineal trauma following childbirth

Abstract

Perineal trauma is any type of injury to the perineum, ranging from haematomas and lacerations to third and fourth-degree tears. This study aimed to explore women’s experience of perineal trauma following childbirth. This was achieved by understanding how perineal trauma influences women’s daily activities; the advice and support given to women with perineal trauma and by understanding how women cope with perineal trauma. A qualitative research design was adopted and a purposive sample of eight women recruited from health centres across Malta via an intermediary at their 6-week postpartum visit. A semi-structured interview tool was specifically designed for the study and interviews were held virtually when participants were between 7 and 10 weeks postpartum. All recruited participants took part in the interviews, yielding a 100% response rate. The interviews were audio-recorded with the participant’s consent and pseudonyms were used to maintain anonymity. The data collected was transcribed verbatim and then translated from Maltese to English for academic purposes. The data was then analysed using thematic analysis and categorised into five themes: the initial experience of perineal trauma; the physical experience of perineal trauma; the emotional experience of perineal trauma; coping with perineal trauma; and support and advice. The findings showed how participants experienced a lack of information concerning the type of trauma they sustained. Participants explained how their perineal trauma had an impact on their daily living including affecting their ability to walk, shower and even open their bowels. Participants also described the physical symptoms experienced which included a burning sensation, swelling and even scarring. Some of these symptoms led to delayed recovery. The perineal trauma that mothers sustained also led to feelings of fear, anxiousness and frustration and the physical relationship with their partners was also impacted. The women described using analgesics, cold compresses, and saline as well as seeking reassurance from healthcare professionals as forms of coping. This study brought forward several implications and recommendations for practice, research, and education. This study stresses the importance of offering adequate information to mothers about their perineal trauma and its recovery, encouraging continuity of care between healthcare professionals, and improving the ward environment to encourage periods of rest. Additionally, it was recommended that further education is given to mothers in the antenatal period regarding perineal trauma. This study recommends future research on the topic using a large, mixed-methods study which will enable generalisability of the findings and will further enhance our understanding of this experience in an attempt to better support women.