Women’s experiences following severe perineal trauma: a qualitative study

Abstract

BackgroundLiterature reports that the psychological impact for women following severe perineal trauma is extensive and complex, however there is a paucity of research reporting on women’s experience and perspective of how they are cared for during this time. The aim of this study was to explore how women experience and make meaning of living with severe perineal trauma.MethodsA qualitative interpretive approach using a feminist perspective guided data collection and analysis. Data were collected through semi-structured face to face interviews with twelve women in Sydney, Australia, who had experienced severe perineal trauma during vaginal birth. Thematic analysis was used to analyse the data.ResultsThree main themes were identified: The Abandoned Mother describes how women feel vulnerable, exposed and disempowered throughout the labour and birth, suturing, and postpartum period and how these feelings are a direct result of the actions of their health care providers. The Fractured Fairytale explores the disconnect between the expectations and reality of the birth experience and immediate postpartum period for women, and how this reality impacts upon their ability to mother their newborn child and the sexual relationship they have with their partner. A Completely Different Normal discusses the emotional pathway women travel as they work to rediscover and redefine a new sense of self following severe perineal trauma.ConclusionHow women are cared for during their labour, birth and postnatal period has a direct impact on how they process, understand and rediscover a new sense of self following severe perineal trauma. Women who experience severe perineal trauma and associated postnatal morbidities undergo a transition as their maternal body boundaries shift, and the trauma to their perineum results in an extended physical opening whereby the internal becomes external, and that creates a continual shift between self and other.

A systematic mixed studies review of women's experiences of perineal trauma sustained during childbirth

“…The general consensus demonstrated through women's accounts, is that perineal trauma is poorly understood, regardless of the extent of the injury. Women with OASI (Priddis, Schmied, & Dahlen, ) described how they sought to find an explanation for the cause of their injuries and how being given little or no information, led to feelings of abandonment (Priddis, Schmied, & Dahlen, ). Without an adequate explanation, beliefs about the cause of the tear were either internally focussed, (e.g.…”

Relationships between perineal pain and postpartum depressive symptoms: A prospective cohort study

“…Perineal pain affects approximately one-third of primiparous women and is associated with perineal traumas (Francisco et al, 2014). Severe perineal trauma affects women's ability to care for their newborn child and their sexual relationship with their partner (Priddis et al, 2014). Perineal lacerations and depressed mood are correlated with each other (Dunn et al, 2015).…”

Posttraumatic stress symptomatology following exposure to perceived traumatic perinatal events within the midwifery profession: The impact of trait emotional intelligence

“…It is possible that the reduced risk of PTSS is linked to reduced empathy, which supports previous research finding that empathy increases risk of developing PTSS in healthcare professionals (Leinweber & Rowe, ; Sheen et al., ). This is concerning, as reduced empathy in midwives has been linked to poor psychological outcomes in women (Priddis et al., ; Thomson & Downe, ).…”