Postnatal perineal pain after vaginal delivery in comprehensive and specialised hospitals in Amhara regional state, Ethiopia, April to June, 2023

Abstract

Background: Millions of women suffer from perineal trauma during childbirth which is the most common cause of postnatal compliant that lasts for hours, days, weeks, or even months. It is the most common source of postnatal morbidity. Hypothesis: There is not clinically significant postnatal perineal pain after vaginal deliveries Objective:The objective of this study was to determine postnatal perineal pain and associated factors among women who had vaginal deliveries. Methods: A multicentre prospective follow-up study was conducted, including a total of 374 women who delivered vaginally at comprehensive specialised hospitals in the Amhara Regional State, Ethiopia, from April 1 to June 30, 2023. Simple random sampling techniques were used to select the samples. Descriptive statistics and logistic regression were performed to determine the incidence of moderate to severe perineal pain, and the association was presented as an odds ratio with a 95% confidence interval. All p-values less than 0.05 were considered statistically significant. Results: The final data analysis includes 356 women out of 374 with a 95% response rate. The incidence of moderate to severe pain was 213 (59.8%) [95%, CI =54.8-65.4], 126 (35.4%) [95%, CI =30.6-39.9], and 30 (8.4%) [95%, CI =5.6-11.8] at days one, three and seven respectively. On postnatal day one, higher level of education [AOR =3.62, 95%, CI (0.99-13.08)], primiparity [AOR =3.22, 95%, CI=1.91-5.42)], episiotomy [AOR =11.90, 95%, CI=5.98-23.75)], and instrumental delivery [AOR =4.54, 95%, CI=1.593-12.91)] were significantly associated with postnatal perineal pain. On the 3rd postnatal day, primiparous [AOR =2.66, 95 %, CI=1.57-4.50)], first degree tear [AOR =7.98,95%,CI=3.06-20.77)], 2nd degree tear [AOR =12.48,95%, CI=4.9031.79)], and 3rd to 4th degree tear [AOR =10.13,95%,CI=3.013-34.04)] were again significantly associated with postnatal perineal pain. On the seventh postnatal day, Episiotomy [AOR =9.76, 95%, CI=2.19-43.54)], 2nd degree tear [AOR =5.51, 95%, CI=1.024-29.618)], and 3rd -4th degree tear [AOR =8.75,95%, CI=1.325-7.822)] were also had a significant association with postnatal perineal pain.. Conclusion: The incidence of moderate to severe postnatal perineal pain remains high. Based on this result, we recommend health care providers consider and act accordingly to prevent and treat postnatal perineal pain.