Midwives’ perspectives on perineal suturing in midwifery practice

Abstract

Perineal suturing is the repair of perineal trauma which is caused by a tear or an episiotomy. This small-scale quantitative research project aimed to investigate midwives’ perspectives on perineal suturing in midwifery practice. This was achieved through the following objectives: to identify effective ways of teaching and supporting midwives in implementing perineal suturing as a midwifery skill and to identify the barriers and facilitators associated with implementing perineal suturing in local midwifery practice. A total of 40 midwives recruited by convenience sampling, were selected from a labour ward of a local general hospital. A total of 35 questionnaires were returned resulting in an 87.5% response rate. Analysis of closed-ended questions was carried out manually using simple descriptive statistics and analysis of open-ended questions was carried out using content analysis. Results suggested that midwives believe that perineal suturing should be carried out by midwives who should be the main professional to suture first and second-degree tears. This would contribute to providing continuity of care to intrapartum women and hence was viewed as imperative in facilitating the implementation of suturing of the perineum by midwives. Establishing perineal suturing by midwives within the local context would facilitate time management concerning care following the birth. Findings suggested that regular training on perineal repair would help to support the practice of the skill. Midwives also claimed that obstetric led care and a lack of trust between healthcare professionals are barriers whilst the provision of training is seen as a facilitator in promoting this midwifery skill. In conclusion, this study recommends the commencement of midwives repairing first-degree and second-degree tears as part of their practice with a policy that supports this. Moreover, further studies using a larger, randomly selected sample of midwives is also recommended so that the findings can be generalized. Recommendations for education include the importance of regular perineal repair courses which should be offered as a form of Continued Professional Development (CPD) to enhance the knowledge on the subject and so that any additional updates can be provided. This study was the first local study investigating midwives’ perspectives on perineal suturing in midwifery practice.