Optimizing and enhancing perineal repair knowledge and teaching among obstetricians and midwives: A prospective three‐site study

Abstract

ObjectivesPerineal assessment and repair are fundamental to providing quality obstetric and midwifery care to women. Up to 80% of women sustain perineal trauma during vaginal delivery, and 70% require repair. This study aimed to establish baseline perineal anatomy knowledge, training exposure, and experience, and to assess whether ongoing training is needed to strengthen perineal repair education and skills.MethodsThis is a prospective multicenter observational study. Obstetricians and midwives actively involved in perineal repair were recruited in three maternity units between April and July 2024. A pre‐survey was completed. A teaching intervention was delivered to participants. After the teaching intervention, a post‐survey was completed. The sample size was appropriately powered and the data were analyzed accordingly.ResultsDuring the study period, 89 clinicians completed the pre‐survey, and 72 attended the training initiative and completed the post‐survey. A total of 84.3% of clinicians had prior training in assessing perineal injury, and 83.1% had some form of practical training in perineal repair. Only 75.3% had received training on assessing for obstetric anal sphincter injury. A total of 88.8% of clinicians felt confident performing an episiotomy, and only 69.7% felt confident in repairing an episiotomy. After the teaching intervention, the post‐survey responses highlighted significant improvement in anatomical knowledge among clinicians conducting perineal repair (P = 0.0078).ConclusionsOngoing learning is necessary for clinicians who are actively completing perineal repair. It results in increased knowledge, which should impact the quality of care for women requiring perineal repair.

Comparative effectiveness of physical interventions for preventing perineal trauma during vaginal delivery: a systematic review and Bayesian network meta-analysis

“…Antenatal pelvic floor exercise is identified as a promising first-line strategy supported by moderate-certainty evidence, with warm compresses and massage representing evidence-informed intrapartum alternatives. Broader implementation and rigorous prospective evaluation of these strategies, particularly among underrepresented populations and in varied clinical settings, could contribute to reducing the burden of perineal trauma and improving maternal outcomes ( 63 , 64 ).…”

Comparative effectiveness of physical interventions for preventing perineal trauma during vaginal delivery: a systematic review and Bayesian network meta-analysis

“…Antenatal pelvic floor exercise is identified as a promising first-line strategy supported by moderate-certainty evidence, with warm compresses and massage representing evidence-informed intrapartum alternatives. Broader implementation and rigorous prospective evaluation of these strategies, particularly among underrepresented populations and in varied clinical settings, could contribute to reducing the burden of perineal trauma and improving maternal outcomes ( 63 , 64 ).…”

Lactic Acid-Loaded Hydrogels for Post-Episiotomy Wound Healing: Microenvironment Engineering and Regenerative Strategies—A Narrative Review

“…Obstetric wounds comprise a heterogeneous group of tissue injuries arising during childbirth, most commonly including spontaneous perineal tears, episiotomy-related incisions, and cesarean section wounds [ 1 ]. Although these injuries differ in anatomical depth, tissue composition, and surgical context, they share a common clinical importance: their healing quality directly influences postpartum recovery, pain, infection risk, scar formation, sexual function, and overall maternal well-being [ 2 ]. In contemporary obstetric care, these wounds are often approached from a procedural or surgical perspective; however, their subsequent repair is also a biologically complex regenerative process shaped by local tissue conditions and systemic host factors [ 2 , 3 ].…”

Comparative effectiveness of physical interventions for preventing perineal trauma during vaginal delivery: a systematic review and Bayesian network meta-analysis

“…Antenatal pelvic floor exercise is identified as a promising first-line strategy supported by moderate-certainty evidence, with warm compresses and massage representing evidence-informed intrapartum alternatives. Broader implementation and rigorous prospective evaluation of these strategies, particularly among underrepresented populations and in varied clinical settings, could contribute to reducing the burden of perineal trauma and improving maternal outcomes ( 63 , 64 ).…”

Lactic Acid-Loaded Hydrogels for Post-Episiotomy Wound Healing: Microenvironment Engineering and Regenerative Strategies—A Narrative Review

“…Obstetric wounds comprise a heterogeneous group of tissue injuries arising during childbirth, most commonly including spontaneous perineal tears, episiotomy-related incisions, and cesarean section wounds [ 1 ]. Although these injuries differ in anatomical depth, tissue composition, and surgical context, they share a common clinical importance: their healing quality directly influences postpartum recovery, pain, infection risk, scar formation, sexual function, and overall maternal well-being [ 2 ]. In contemporary obstetric care, these wounds are often approached from a procedural or surgical perspective; however, their subsequent repair is also a biologically complex regenerative process shaped by local tissue conditions and systemic host factors [ 2 , 3 ].…”

Comparative effectiveness of physical interventions for preventing perineal trauma during vaginal delivery: a systematic review and Bayesian network meta-analysis

“…Antenatal pelvic floor exercise is identified as a promising first-line strategy supported by moderate-certainty evidence, with warm compresses and massage representing evidence-informed intrapartum alternatives. Broader implementation and rigorous prospective evaluation of these strategies, particularly among underrepresented populations and in varied clinical settings, could contribute to reducing the burden of perineal trauma and improving maternal outcomes ( 63 , 64 ).…”

Lactic Acid-Loaded Hydrogels for Post-Episiotomy Wound Healing: Microenvironment Engineering and Regenerative Strategies—A Narrative Review

“…Obstetric wounds comprise a heterogeneous group of tissue injuries arising during childbirth, most commonly including spontaneous perineal tears, episiotomy-related incisions, and cesarean section wounds [ 1 ]. Although these injuries differ in anatomical depth, tissue composition, and surgical context, they share a common clinical importance: their healing quality directly influences postpartum recovery, pain, infection risk, scar formation, sexual function, and overall maternal well-being [ 2 ]. In contemporary obstetric care, these wounds are often approached from a procedural or surgical perspective; however, their subsequent repair is also a biologically complex regenerative process shaped by local tissue conditions and systemic host factors [ 2 , 3 ].…”