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Updated: Dec 11, 2025

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Perineal management: Midwives' confidence and educational needs.

Lorraine Carroll1, Lucille Sheehy2, Jean Doherty2

  • 1School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.

Midwifery
|August 18, 2020
PubMed
Summary

Midwives desire enhanced education on preventing perineal trauma during childbirth. Updated training programs can improve skills, confidence, and reduce birth-related perineal injuries.

Keywords:
MidwivesMidwives' confidenceMidwives' educational needsPerineal managementSecond stage of labour

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Area of Science:

  • Obstetrics and Gynecology
  • Midwifery Education
  • Women's Health Research

Background:

  • Midwives' expertise in perineal management is crucial for preventing birth-related trauma.
  • Existing educational programs may not adequately address the prevention of perineal trauma.
  • There is a need to understand midwives' current confidence and educational requirements.

Purpose of the Study:

  • To explore midwives' confidence and educational needs in managing the perineum during the second stage of labor.
  • To inform the development of updated perineal management educational programs for midwives.
  • To identify quality initiatives for improving midwives' expertise in preventing perineal trauma.

Main Methods:

  • A mixed-methods sequential exploratory design was employed.
  • Data were collected from midwives and clinical midwife managers in a large urban maternity hospital.
  • Questionnaires and focus groups were utilized for data collection.

Main Results:

  • A high response rate (81.2%) was achieved with 52 midwives participating.
  • Most midwives (85%) desired further education on preventing perineal trauma, noting current workshops focus on repair rather than prevention.
  • Experienced midwives reported higher confidence in procedures like episiotomy; midwives recommended improvements in education content, format, and delivery.

Conclusions:

  • Midwives express a strong demand for additional education in perineal management, particularly in trauma prevention strategies.
  • Regular, evidence-based education tailored to midwives' needs can enhance clinical skills and confidence, ultimately reducing perineal trauma.
  • Updating educational programs is essential for improving perineal protection techniques and reducing trauma rates in spontaneous vaginal births.