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Updated: Jul 19, 2026

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse (POP) Quantification System
Published on: September 20, 2018
Getting evidence into obstetric and midwifery practice: reducing perineal trauma
Michael C Nicholl1, Miriam A Cattell
1Division Women's Children's and Family Health, Royal North Shore Hospital, St Leonards, Sydney, NSW 2065, Australia. mnicholl@nsccahs.health.nsw.gov.au
Problem:
Frequent obstetric perineal morbidity in a hospital setting with service providers inexperienced in getting evidence into practice.
Design:
Clinical practice improvement methodology in a tertiary referral obstetric unit.
Strategies For Change:
To cease active instruction to push in the second stage of labour; encourage the adoption of the left lateral position when delivering on a bed; use of the vacuum extractor rather than forceps where instrumental delivery indicated.
Effects Of Change:
Improved perineal outcomes with a 21.5% increase in intact perineum rate and a 100% reduction in fourth degree perineal tears.
Lessons Learned:
Clinical practice improvement methodology is a useful tool for getting evidence into practice, resulting in improved clinical outcomes.
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