Women's experiences following severe perineal trauma: a meta‐ethnographic synthesis

Abstract

There is evidence to suggest that for women who experience severe perineal trauma during childbirth the physical and psychological outcomes can be complex, with some women experiencing social isolation and marginalization due to their ongoing symptomatology. Severe perineal trauma appeared to affect not only physiological and psychological well-being but also altered the women's understanding of their identity as sexual beings. Health professionals should be mindful of the language that they use and their actions during suturing and the postpartum period to avoid causing unnecessary distress.

Postpartum sexual health: a principle‐based concept analysis

“…Acknowledging these lack of recommendations, some meaningful application of the concept to clinical practice was identified in the dataset. For example, early and individualized (i.e., tailoring the information to the woman's specific circumstances) education on possible changes to sexual health, in so much as consultations take place prior to discharge from maternity services, was highlighted (Rogers et al 2009, Priddis et al 2013. This indicates that perhaps some thought is being given to the applicability of postpartum sexual health to clinical practice, but, as yet, this consideration is minimal.…”

“…Antecedents to postpartum sexual health must, therefore, consist of factors that contribute to being a sexually healthy person after birth. The scientific literature identifies factors, albeit for heterosexual women, that increase the likelihood of being sexually healthy after birth as an instrument free birth (Thompson et al 2002, Buhling et al 2006, Bertozzi et al 2010, an intact perineum (Williams et al 2007, McDonald & Brown 2013, avoidance of an episiotomy (Rathfisch et al 2010) and being free of a 3rd or 4th degree perineal tear (Marsh et al 2011, Priddis et al 2013. There is some inference that caesarean section is protective of sexual health, however, compared with vaginal birth, this safeguard was short term (up to 3 months) and was non-existent at 12 months postbirth (Barrett et al 2005, Klein et al 2009.…”

Midwives’ lived experience of a birth where the woman suffers an obstetric anal sphincter injury - a phenomenological study

“…The consequences of these injuries can be devastating for women [2] and involve symptoms such as perineal pain, dyspareunia [3] and faecal incontinence [4]. Obstetric anal sphincter injuries also prolong the time from birth until sexual intercourse is resumed [5].…”

“…Furthermore women’s experiences of severe perineal trauma and obstetric anal sphincter injuries have been described. The experience of obstetric anal sphincter injuries during childbirth appears to be a complex phenomenon that affects the women both physiologically and psychologically and alters the women’s understanding of their identity as sexual beings [2]. …”

The effect of maternal position at birth on perineal trauma: A systematic review

“…These morbidities can lead to women experiencing complex psychological issues such as social isolation, anxiety, embarrassment and avoidance of intimate contact due to fear of pain (Priddis et al, 2013, Williams et al, 2005, O'Reilly et al, 2009. Also women may fear and anticipate pain during the suturing process (Priddis et al, 2013), an intervention which can blight an otherwise satisfying birth experience.…”