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Getting through birth in one piece: protecting the perineum
Marie Hastings-Tolsma1, Deborah Vincent, Cathy Emeis
1Nurse Midwifery, University of Colorado at Denver & Health Sciences Center, CO, USA. marie.hastings-tolsma@uchsc.edu
Summary
Childbirth perineal trauma can be reduced by using side-lying positions, perineal support, and warm compresses during labor. Nurses should implement these strategies to promote perineal integrity.
Area of Science:
- Obstetrics and Gynecology
- Midwifery
- Perinatal Care
Background:
- Perineal trauma during childbirth is a significant concern.
- Previous studies have identified various risk factors and protective measures.
- Replicating prior work is crucial for validating findings in different populations.
Purpose of the Study:
- To identify clinical factors associated with perineal trauma in childbirth.
- To compare findings with previous research on perineal trauma.
- To inform evidence-based nursing interventions for preventing perineal injury.
Main Methods:
- Retrospective analysis of 510 singleton pregnancies and births.
- Data collected from the Nurse Midwifery Clinical Data Set (1996-1997).
- Multivariate statistical analysis of clinical characteristics and perineal trauma outcomes.
Main Results:
- Episiotomy linked to parity, marital status, infant weight, fetal bradycardia, prolonged second stage labor.
- Lacerations associated with age, insurance, marital status, lithotomy position, and prolonged second stage labor.
- Protective factors included massage, warm compresses, manual support, and lateral birth position; oils/lubricants increased lacerations.
Conclusions:
- Side-lying position and perineal support/compress use are key interventions to decrease perineal trauma.
- Nurses play a vital role in prenatal education and labor care to promote perineal integrity.
- Implementing these strategies can significantly reduce childbirth-related perineal injuries.
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