Perineal care and repair

Perineal trauma can have lifelong effects on the quality of women's lives. Midwives should try to minimise this trauma, and after correctly identifying it should be able to undertake perineal repair competently, using the best suturing techniques and materials, to minimise any associated short- and long-term morbidity. Prevention of perineal trauma, especially the most severe form of trauma (third- and fourth-degree tears), and improvement of second-stage comfort are important components of perineal care. The 'pelvic floor' is the term given to the structures that fill the outlet of the bony pelvis. These muscles have important functions, and disruption to their integrity can have serious consequences for a woman's health. It is important for a midwife to have an understanding of the structure and function of the pelvic floor muscles and perineal body in order to minimise damage and prevent long-term morbidity. Care and advice given to the women, following the birth, regarding her perineum and pelvic floor is often not evidence based and in some cases remains virtually absent. It is important for a women to have the best possible support and advice in the post-natal period in order to be able to care for herself and ensure optimal perineal and pelvic floor muscle health. The midwife's role in giving support and evidence-based advice in the antenatal and postnatal periods can ensure that women minimise long-term morbidity, such as incontinence and sexual dysfunction.