Perineal trauma and childbirth: a discussion paper

Objective: The aim of this paper is to identify midwifery and medical strategies that reduce pain and morbidity resulting from perineal trauma. The question put forward was What midwifery and medical strategies reduce pain and morbidity associated with perineal trauma resulting from birth? Method: A review of the literature was undertaken. Both qualitative and quantitative research-based literature related to perineal pain was examined. Findings: Cold therapy and analgesia reduce pain and oedema in the immediate postnatal period, while pelvic floor exercises reduce incontinence in the longer term. Conclusion: Prevention of perineal trauma is most favourable outcome for birthing women. Where perineal trauma exists, women should be offered analgesia and/or cold therapy to relieve immediate and short-term pain and morbidity. Longer-term morbidity and the incidence of postnatal incontinence is reduced with adherence to exercise programs. Midwives must become more proactive in preventative measures that reduce perineal trauma and provide pain relief strategies when perineal trauma exists.