(205) The Psychological, Sexual, and Financial Impact of Infertility on Couples: An Urological Approach

Introduction Infertility is a public health issue with socioeconomic and demographic impact. Understanding the psychological, sexual, and financial repercussions on couples is crucial for comprehensive treatment. Objective Infertility can evoke complex emotions and disrupt the couple's sexual relationship. The aim of this study is to examine the psychological, sexual, and financial aspects of this condition on infertile couples. Methods A retrospective study was conducted on 50 couples undergoing infertility treatment at a military hospital. Data, including medical records, questionnaires, and follow-up information, were collected. Results 1. Psychological Impact: Infertility represents a failure of the parental project, leading to negative emotions. Women are more likely to report the psychological impact and seek help. Family pressure and potential divorce due to societal expectations were observed. 2. Sexual Impact: Infertility can significantly affect sexual life, causing decreased satisfaction, stress, and anxiety. Communication and emotional intimacy may suffer. Contrary to literature, men reported more sexual disorders due to socio-cultural factors and female partners' discomfort discussing sexuality. 3. Financial Impact: Infertility treatments incur substantial costs, adding to emotional and physical burdens. Financial implications vary by country, and lack of national funding policies lead to debt or abandonment of conception plans. In the study, half of the couples spent over $1000. Conclusions Infertility has a significant psychological, sexual, and financial impact on couples. A comprehensive approach involving healthcare practitioners and policymakers is necessary for significant improvement in the well-being of infertile couples. Disclosure No.

Mentally ill person needs caretakers during hospitalization for severe conditions, continuing care, and rehabilitation. Caretakers experience mental illness when providing care for their mentally ill patients in Nepal. About 24.5% of caretakers had anxiety and 19.6% had depression. The financial, social, and psychological health of caregivers may all impact. The objective was to examine the psychological, financial and social impact on caregivers. A descriptive study was conducted on 207 caregivers’ of mentally ill patients at mental hospital, Nepal. Purposive sampling technique was used. Semi-structured questionnaires were developed to assess psychological and financial impacts and Likert scale questions were included to assess social impact. Information was gathered using a structured face-to-face interview. Impacts on caregivers’ psychological, economic and social were associated to their sociodemographic characteristics. Education, religion, and the patient's length of mental illness were all associated with psychological impact (χ2=54.37; df=5; p= <0.001). Education and the duration of their mental illness are also related to the financial impact (χ2=31.95; df=7; p= <0.001). The social impact experienced by caregivers is similarly associated with education, occupation, and the length of mental illness (χ2=61.03; df=5; p= <0.001). The association between caregivers' sociodemographic factors and the psychological, financial, and social impacts on them was observed. This justifies encouraging caregivers to be a part of the support group in order to increase the information and emotional support they get from other caregivers who have similar experiences. Keywords: Impact, psychological, financial, social, mentally ill patient, caregiver

Introduction: In the COVID-19 pandemic, the implementation of the lockdown led to the closure of dental practices. Restricting treatment to emergency patients, having to use Personal Protective Equipment and the fear of contracting the virus led to modifications in the techniques and methods used to provide efficient dental care to the patients. However, it caused a significant psychological and financial impact on the dental community. The purpose of this research was to evaluate dentists’ perceptions regarding the psychological, financial, and general impact of the COVID-19 pandemic on the reopening of their dental practices. Methods: This cross-sectional analytical study was conducted using a validated questionnaire, which was distributed among 257 dental practitioners working in Karachi through the social media app (WhatsApp®) from May 2021 to May 2022. The questionnaire included four sections and 26 items, recording data for demographics, psychological effects on resumption of dental practices, workplace disinfection, and precautionary measures along financial impacts. Data were analyzed using SPSS, version 21.0. p-value ≤ 0.05 was taken as statistically significant Results: A total of 200 filled questionnaires were received, making the response rate 77%. The majority of respondents were females (67%). More than half of the respondents (55.5%) were working in dental OPDs. Most participants affirmed that they did not have a COVID-19 screening area nor patient triage was being done in dental OPDs. Closure of dental practices caused financial problems for all dental practitioners, more specifically for those that were associated with both public and private types of practices (84.9%). The majority of the dentists in private practice (94.4%) declared that their workplaces were being disinfected, while 47.7% of dental practitioners working in the dental OPD affirmed that they had enough financial stability to keep using Personal Protective Equipment. Approximately 64.9% of professionals practicing in dental OPDs and 33.3% in private practice believed that the reopening of dental practices was responsible for the re-spread of the coronavirus Conclusion: Significant anxiety and stress related to COVID-19 were seen among dental practitioners. Some CDC-recommended guidelines such as the use of Personal Protective Equipment were being implemented whereas COVID-19 screening and patient triage were found deficient.

Financial, resource, and psychological impacts of COVID-19 on U.S. College students: Who is impacted and what are the implications for adjustment and well-being?

Behaviourally bisexual men have been identified as a ‘bridge’ population of HIV transmission to heterosexual women in India. Little is known about the sexual relationships that these men have with their female sex partners. The primary objective of this study was to explore the sexual practices and relationship dynamics between married and unmarried behaviourally bisexual men and their female sex partners in Mumbai, India. In 2009, semi-structured qualitative interviews were conducted with 32 men who reported sex with men and women. Participants discussed a variety of sexual practices and arrangements with female sex partners. Irrespective of marital status and sexual identity, many said that they had satisfying sexual experiences and feelings of affection for female sex partners. However, sexual incompatibility between married partners was also reported. Explanations of bisexual concurrency were discussed in terms of both sexual satisfaction and sexual preference. Self-perceived HIV risk related to same-sex sexual behaviour motivated many men to use condoms with female partners. Expectations of unprotected marital sex and perceptions of partner risk were barriers to condom use. HIV-prevention programmes for this population may benefit from tailored risk-reduction counselling that attends to the variations of these sexual and social relationship dynamics.

Foreign workers comprise a significant portion of Singapore's workforce. They face multiple challenges when working there. A hand injury may add to these stressors, causing profound psychological and social impact. There are few studies in the literaturethat have analyzed this effect.The primary objective of this study, the firstof its kind in Singapore, is to investigate the psychological impact and functional outcomes of hand injuries among foreign workers. By assessing the prevalence of psychological conditions such as stress, anxiety, and depression, along with measuring functional impairment using validated tools, this study aims to provide insights into the psycho-social challenges faced by this vulnerable population. A single-encounter interview was conducted for eligible patients. Psychological impact was measured using the DASS-21, symptom severity and function with the QuickDASH, and pain with the VAS. Injury-specific and demographic data were also collected. The Mann-Whitney U test and the Chi-Squared test were applied for non-parametric variables and categorical data, respectively. The adjusted p-value was <0.05. Eighty foreign workers were recruited. The mean age was 33 years, and the median age was 31.5 years (28.2 to 37.0). The majority were male (97.5%), married (60%), and had a salary of less than SGD1500 (USD1077) per month (81.3%). The most common mechanism of injury was penetrating (60%, n=48). Stress, anxiety, and depression were positively associated with limitations in daily function. Multivariate analysis found that limitations in daily function were independently associated with stress, anxiety, and depression, regardless of hand dominance. Conclusion:This study has shown a significant psychological and social impact of hand injuries among foreign workers in Singapore. There is potential for the development of screening and support programs for at-risk workers to cater to their mental well-being. We recommend that the psychological impact of hand injuries be factored into holistic management and rehabilitation with adequate time and resource allocation. An ancillary benefit is the improvement of productivity and overall contribution to Singapore's economy.

Study question What is the impact of predefined factors, such as hirsutism and BMI, on the quality of life, anxiety-depressive symptoms and sexuality of women with PCOS? Summary answer The quality of life of women with PCOS is influenced by hirsutism, BMI and anxiety-depressive disorders, but little by other factors that were studied. What is known already Polycystic ovary syndrome affects 5-20% of women and is the leading cause of female infertility. The Rotterdam criteria describe it as a condition characterised by ovulatory disorders, hyperandrogenism and/or polycystic ovaries on ultrasound. Treatment tends to address the physical symptoms, despite the significant psychological impact, which can include anxiety, depression, low self-esteem, and a decreased quality of life. Hyperandrogenism and infertility can also affect body image and sexuality, contributing to a reduced overall well-being. Our study is the first to consider the impact of PCOS-related symptoms in a population of diagnosed patients, and not the general population. Study design, size, duration This study was a prospective, observational, monocentric study conducted at the Medical Gynaecology Service an University Hospital. Patient enrolment took place between July 2023 and January 2024. A total of 100 patients were enrolled as per the protocol. The aim of this study was to explore the relationship between their quality of life and predefined factors : age, BMI, menstrual disorders, hyperandrogenism, infertility, parity, socio-professional category, delay in PCOS diagnosis, and history of anxiety. Participants/materials, setting, methods The study involved women diagnosed with PCOS who provided verbal consent. Quality of life was assessed using the PCOSQOL, a specific score evaluating the impact of PCOS, and FACT-G7. HADS and ASEX scores evaluated anxiety, depression, and sexual satisfaction respectively. Bivariate analyses examined the relationships between these scores and predefined factors. Variables linked to quality of life were included in multivariate models. The study also compared scores across PCOS phenotypes (A, C, D) using ANOVA. Main results and the role of chance Patients suffering from hirsutism or with a history of anxiety or depression had significantly lower quality of life scores (p = 0.0015 and p = 0.0014 respectively), while infertility, acne, menstrual disorders, parity or socio-professional category showed no significant differences. A negative correlation was observed between BMI and quality of life (r = 0.05, p &amp;lt; 0.001). Age, time to diagnosis or to infertility had no significant influence. For the FACT G7 and HADS scores, a history of anxiety increased the scores, indicating a psychological impact (p = 0.013 and p &amp;lt; 0.001 respectively). Patients with hirsutism had higher HADS and depression scores (p = 0.0064), and a positive correlation was also observed between BMI and HADS score (r = 0.24, p = 0.018). Almost 45% of patients had a high anxiety score and 17% a high depression score. No significant association was found between the ASEX score and hirsutism, anxiety or BMI, although a high score was observed in 39% of respondents. Phenotypes A, C and D showed no significant difference in scores, but phenotype B could not be assessed due to its rarity. Limitations, reasons for caution Several of the variables studied had results close to significance, perhaps because of a limited number of patients. New studies with greater power and a larger number of patients might show a significant difference in these factors. Wider implications of the findings Patients with PCOS require multidisciplinary management, taking into account the psychological and social impact of their symptoms. Based on our results, systematic screening for anxiety-depressive symptoms and impaired quality of life should be considered, especially in patients with hirsutism, obesity, or a history of anxiety-depressive disorders. Trial registration number Yes

Introduction Studies suggest that changes in sexual health and relationship satisfaction are common in women during pregnancy and postpartum, however these are often overlooked during postpartum care. Furthermore, one in seven women experience additional challenges of postpartum depression within the first postnatal yea. Studies have recognized depression as a major predictor for reduced sexual desire and satisfaction. There is little empirical data on the impact of postpartum depression on the sexual health of both male and female partners and relationship satisfaction. Objective This study assesses the relationship between postpartum depression, relationship satisfaction, and sexual satisfaction at three postpartum time points: immediate, six weeks, and twelve weeks postpartum, in postpartum patients and their partners. Methods This longitudinal study was conducted on heterosexual couples recruited from the postpartum unit, excluding patients with pregnancy complications. Each partner was consented immediately postpartum and individually surveyed to evaluate their sexual desire, relationship satisfaction, and sexual dysfunction immediately, 6 weeks, and 12 weeks postpartum. The Sexual Desire Inventory-2, Sexual Dysfunction Questionnaire, and Couples Satisfaction Index were utilized. Mothers were additionally screened for postpartum depression using the Edinburgh Postnatal Depression Scale at the three time points. We then conducted a retrospective chart review from 6 and 12 week postpartum visits to investigate delivery details and sexual dysfunction screening as reported in clinic documentation. Results This sample consisted of 89 female (54.60%), and 74 male (45.40%). 5 had postpartum depression at least 1 timepoint (8.20%). Sexual desire differed significantly between female and male partners over the entire postpartum period (p &amp;lt; 0.01), and relationship satisfaction differed significantly over time throughout the postpartum period across both female and male partners (p &amp;lt; 0.01). Across the entire postpartum period, female partner sexual desire scores were, on average, 7.02 units lower than male partner sexual desire scores (Mean Difference; 95% CI: -7.02; -11.02, -3.02), meaning that female partner sexual desire was significantly lower than male partner sexual desire throughout the postpartum period. For both female and male partners, relationship satisfaction scores were significantly lower at 12 weeks postpartum (p &amp;lt; 0.01) and at 6 weeks postpartum (p &amp;lt; 0.01) as compared to immediately postpartum, meaning that both female and male partners were significantly less satisfied with their relationships at 6 weeks postpartum and at 12 weeks postpartum as compared to immediately postpartum. 82% females were not screened for sexual dysfunction at 6 weeks postpartum and 2% were screened. Conclusions Discrepancy in relationship satisfaction and sexual desire between male and female partners was found throughout the postpartum period. Yet, a majority of patients are not screened for sexual dysfunction at their 6 week postpartum visit. These findings elucidate the need to normalize and address sexual health during the postpartum period as standard of care, including screening and treatment, in both male and female partners. Disclosure No.

IntroductionSince COVID19 pandemic emergence, containment measure have been taken by the Tunisian government imposing a new lifestyle resulting in psychological repercussions and a change in behavior.ObjectivesHighlighting changes of behavior and lifestyle of the general public secondary to the COVID19 pandemic and to confinement and to assess their levels of psychological.Methods This is a qualitative, descriptive and analytical cross-sectional study realized between April and May 2020 with the general public using an anonymous online questionnaire covering: socio-demographic data; behavior during confinement; epidemic psychological impact; Mental health status was measured using Depression, Anxiety and Stress Scale(DASS-21). Anger level was assessed by STAXI-10 items.Results132 responses were received: 68.2% were women; the average age 32.01(±11.10); half were single; 77.3% were at higher education level; 41.7% were healthcare professionnels. Consumption increased by 26.5% in coffee, 8.3% tobacco and 1.5% alcohol. 33.3% of participants increased their religious practice. 56.1% experienced sleep disorder mostly women(p&lt;0.05). 91.7% followed COVID19 evolution through media essentially Facebook. Partners relationship was deteriorated in1.7% and improved in 25%. Child abuse increased by 13.7%. During confinement: 15.9%depression (0.8%severe depression), 12.9%anxiety (0.8%severe anxiety), 5.3% stress and 27.3%feelings of anger. Depression, anxiety and anger were related to younger age(p&lt;0.05). Stress wasn’t age related. Depression was observed in participants without children (p&lt;0.05). No association founded between psychological impact and gender, profession and civil status.ConclusionsThe COVID19 pandemic and the containment had consequences on individuals behavior and mental health. A psychological listening unit was launched during the period of confinement to overcome psychological impact.

Introductionprendre en charge un patient psychotique est associé à un risque d´exposition à la violence qui peut toucher tous les intervenants, en particulier l´entourage familial. La violence que la fonction d´aide engendre peut avoir un impact psychologique sur l´aidant. Nos objectifs étaient de relever la prévalence des agressions perpétrées par les patients psychotiques envers leurs aidants familiaux, évaluer l´impact psycho-traumatique chez eux et identifier les facteurs qui lui sont associés.Méthodesdes aidants familiaux de patients psychotiques ont été interviewés. Nous avons utilisé deux échelles psychométriques: l´échelle de perception de la prévalence de l´agression et l´échelle révisée d´impact de l´événement.Résultatsle nombre total des participants était de 95. Trois aidants sur quatre (75,8%) ont rapporté avoir été victimes d´agression modérée à sévère de la part de leurs proches malades durant l´année écoulée. Une agression modérée à sévère était significativement plus fréquente chez les aidants de sexe masculin, d´un âge plus avancé, parents de patient psychotique et vivant dans un autre foyer que lui. Un taux de 54,7% des aidants présentait un état de stress post-traumatique (ESPT) probable et le risque d´apparition de ce trouble augmentait significativement avec l´intensité perçue des agressions. Le même profil sociodémographique de l´aidant lié à la gravité des agressions était à risque de développement d´un ESPT chez l´aidant.Conclusionles agressions commises par les patients psychotiques sur leurs aidants familiaux paraissent avoir un impact psycho-traumatique important. Aussi, des interventions ciblant la violence des malades psychotiques dans leur milieu familial devraient être intégrées dans la prise en charge.

RESUMENFundamentos: La emergencia socio-sanitaria provocada por la COVID-19 puede tener un importante impacto psicológico en la población. Por este motivo, resulta necesario identificar los grupos sociales especialmente vulnerables al impacto de la pandemia y los factores de protección que pueden reducirlo, lo que constituyó el objetivo de este estudio. Métodos: Mediante muestreo tipo bola de nieve, 1.596 personas residentes en España durante la cuarentena contestaron un cuestionario online que incluyó información sobre variables sociodemográficas, síntomas y contacto con la enfermedad, percepción del riesgo, conductas para prevenir el contagio y estrategias para afrontar la cuarentena. El impacto psicológico se evaluó mediante la Escala de Impacto de Evento-Revisada (IES-R), y el estado de salud mental con el Cuestionario de Salud General de Goldberg (GHQ-12). Mediante diferentes modelos de regresión lineal simple se analizó la relación de las variables del estudio con el impacto psicológico de la pandemia y la salud mental de los participantes.Resultados: El 24,7% de los participantes presentó un impacto psicológico moderado o severo y el 48,8% mostró deterioro de la salud mental. Las mujeres, los estudiantes y la población con menor nivel de ingresos económicos, además de con menos espacio disponible por persona en la vivienda, presentaron mayor impacto psicológico y peor salud mental. Convivir con personas de riesgo y prever los efectos económicos negativos de la crisis socio-sanitaria elevaron el malestar emocional y la morbilidad psíquica. Aunque las medidas para prevenir el contagio no se relacionaron con el impacto psicológico, determinadas estrategias de afrontamiento sí ayudaron a reducirlo. Conclusiones: Estos hallazgos perfilan la existencia de determinados grupos sociales especialmente sensibles al impacto de la pandemia, y sugieren líneas de acción que ayuden a reducir las secuelas psicosociales de la COVID-19.

BackgroundThe pandemic of Corona Virus (COVID-19) hit India recently; and the associated uncertainty is increasingly testing psychological resilience of the masses. When the global focus has mostly been on testing, finding a cure and preventing transmission; people are going through a myriad of psychological problems in adjusting to the current lifestyles and fear of the disease. Since there is a severe dearth of researches on this issue, we decided to conduct an online survey to evaluate its psychological impact.MethodsFrom 26th to 29th March an online survey (FEEL-COVID) was conducted using principles of snowballing, and by invitation through text messages to participate. The survey collected data on socio-demographic and clinical variables related to COVID-19 (based on the current knowledge); along with measuring psychological impact with the help of Impact of Event–revised (IES-R) scale.ResultsThere were a total of 1106 responses from around 64 cities in the country. Out of these 453 responses had at least one item missing; and were excluded from the analysis. The mean age of the respondents was around 41 years with a male female ratio of 3:1 and around 22% respondents were health care professionals. Overall approximately one third of respondents had significant psychological impact (IES-R score > 24). Higher psychological impact was predicted with younger age, female gender and comorbid physical illness. Presence of physical symptoms and contact history predicted higher psychological impact, but did not reach statistical significance.ConclusionDuring the initial stages of COVID-19 in India, almost one-third respondents had a significant psychological impact. This indicates a need for more systematic and longitudinal assessment of psychological needs of the population, which can help the government in formulating holistic interventions for affected individuals.

What do couples referred to or attending a recurrent pregnancy loss (RPL) clinic believe they need in terms of treatment, support and follow up? Men and women wish for more information, earlier access to treatment, support and follow up that is sensitive to their history of pregnancy loss (PL), includes both members of the couple, and acknowledges the psychological impact of RPL. Previous research has highlighted women's dissatisfaction with medical care provided post-PL and their desire for medical professionals to have increased awareness about PL and recognition of the psychological impact of PL. Less is known about the needs of the male partner, the needs of those experiencing RPL and whether the needs differ during different reproductive stages. Over a 2-month period in 2017-2018, 13 couples who were referred to the national RPL program in Copenhagen, Denmark were qualitatively interviewed. Inclusion criteria were heterosexual couples with at least three consecutive PLs before 12 weeks' gestation with no children or one child prior to the PLs, not currently pregnant, and willing to be interviewed in English. Couples were interviewed together in a semi-structured format. Data were analyzed using thematic analysis. Invitations (n = 30) were sent to couples recently referred to the RPL program who indicated an interest in participating and 17 couples contacted the interviewer to schedule an interview. Due to cancellations, 15 interviews were held. Data from 13 interviews that met the study criteria were used for the current analysis. The participants had experienced a median of three PLs (range 3-6). Both men and women described the cumulative effect of RPL with an increase in pressure and exhaustion by the third and subsequent losses. Inclusion of the male partner in consultations and treatment was seen as important. Men felt pressured to remain positive and support their partners despite their own feelings of loss. The findings showed that couples desired reliable and accurate information about RPL. They wished for recognition from the medical community that RPL has a significant psychological impact, and stressed that effective treatment should include both members of the couple, with attention to both physical and psychological aspects of the RPL and should be tailored to their current reproductive stage, in order to help them cope with the negative impact of RPL and the anxiety associated with conception and another pregnancy. Participants were self-selected thus findings cannot be generalized to all couples with RPL. This is the first study addressing the needs of the female and male partners in couples suffering from RPL. The findings highlight a disconnect between couples' perceived needs and their experience of medical care after RPL. This may be partly due to a discrepancy in couples' and medical professionals' perceptions of the PLs. The findings highlight that medical professionals need to take a holistic and couple-focused approach in their treatment of RPL and include attention to the psychological impact and cumulative effect of the multiple PLs on the couple. The results underscore the need for informational resources and psychological support for couples experiencing RPL, tailored to their reproductive stage. EK was funded by a Travel/Training Fellowship from ReproUnion, co-financed by the European Union, Interreg V ÖKS. No other competing interests were declared. N/A.

Psychological and professional impact of COVID-19 lockdown on French dermatologists: Data from a large survey

The female perineum becomes suffused and stretched during pregnancy, and further strain during vaginal childbirth contributes to approximately 85% of women experiencing some degree of trauma to the perineal region. Multiple factors play a role in the type and severity of trauma experienced, including parity, delivery method, and local practices. There is ongoing debate about best midwifery practice to reduce perineal trauma. Once perineal trauma has occurred, treatment also varies greatly, depending on its degree and severity, local practice and customs, and personal preference. In order to optimise wound-healing outcomes, it is important that wounds are assessed and managed in an appropriate and timely manner. A perineal wound may cause significant physical and/or psychological impact in the short or long term, however little evidence is available on this subject.Antenatal education serves to prepare women and their partners for pregnancy, delivery and the postpartum period. The delivery of this education varies widely in type, content, and nature. This review examined antenatal education which is specifically tailored towards perineal care and wound healing in the postnatal period via formal channels. Appropriate patient education positively impacts on wound-healing rates and compliance with wound care. Risk factors that contribute to the breakdown of wounds and poor healing rates may be addressed antenatally in order to optimise postnatal wound healing. It is important to assess whether or not antenatal wound-care education positively affects perineal healing, in order to empower women to incorporate best practice, evidence-based treatment with this important aspect of self-care in the immediate postnatal period. To evaluate the effects of antenatal education on perineal wound healing in postnatal women who have birthed in a hospital setting, and who have experienced a break in the skin of the perineum as a result of a tear or episiotomy, or both. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2017), ClinicalTrials.gov (8th September 2017), the WHO International Clinical Trials Registry Platform (ICTRP) (8th September 2017) and reference lists of retrieved studies. We considered randomised controlled trials (RCTs) which referred to all formal methods of antenatal education and addressed care of a potential perineal wound as a result of a tear or episiotomy, which was experienced by pregnant women who planned to give birth within a hospital setting.Trials using a cluster-RCT and a quasi-randomised design would have been eligible for inclusion in this review but none were identified. Cross-over trials were not eligible for inclusion in this review. Studies published in abstract form would have been eligible for inclusion in this review, but none were identified.We planned to consider all formal methods of antenatal education which addressed care of a perineal wound. We also planned to consider all contact points where there was an opportunity for formal education, including midwifery appointments, antenatal education classes, obstetrician appointments, general practitioner appointments and physiotherapist appointments. Two review authors independently assessed titles and abstracts of the studies identified by the search strategy for their eligibility. No studies met the inclusion criteria for this review. We excluded one study and one other study is ongoing. We set out to evaluate the RCT evidence pertaining to the impact of antenatal education on perineal wound healing in postnatal women who have birthed in a hospital setting, and who experienced a break in the skin of the perineum as a result of a tear or episiotomy, or both. However, no studies met the inclusion criteria. There is a lack of evidence concerning whether or not antenatal education relating to perineal wound healing in this cohort of women will change the outcome for these women in relation to wound healing, infection rate, re-attendance or re-admission to hospital, pain, health-related quality of life, maternal bonding, and negative emotional experiences. Further study is warranted in this area given the significant physical, psychological and economic impact of perineal wounds, and the large proportion of childbearing women who have experienced a postnatal wound. The benefits of any future research in this field would be maximised by incorporating women in a range of socio-economic groups, and with a range of healthcare options. This research could take both a qualitative and a quantitative approach and examine the outcomes identified in this review in order to assess fully the potential benefits of a tailored antenatal package, and to make recommendations for future practice. There is currently no evidence to inform practice in this regard.