A women-centred exploration of postpartum perineal pain when the perineum is diagnosed as intact: A French Gadamerian research study

Abstract

BackgroundPostpartum perineal pain is a frequent symptom (90%) with consequences on postnatal health regardless of whether the perineum remains intact. The impact of that pain on both short and long-term health has been studied and literature suggests midwives have a role to play in addressing this issue. However, the determinants of perineal pain when no lesions are identified are under researched and there is little understanding of women's views on this topic. Aim and objectivesThe aim of the study was to gain an understanding of postpartum perineal pain when the perineum is considered to be intact. The objectives were•To gain an understanding of postpartum pain and its consequences on health and well-being•To explore women's views and understanding of perineal pain postpartum•To gain an understanding of the determinants of postpartum perineal pain when no anatomic lesion is diagnosed. MethodsA Gadamerian hermeneutic approach was used to achieve a shared understanding of the issue. Participants were recruited from two maternity hospitals in the French area of Vaucluse. All women aged 18 to 45 years old, having given birth vaginally to a single live child and diagnosed with an intact perineum, were invited to participate in face-to-face interviews. Eleven participants were interviewed once, six of whom agreed to a second interview which took place over the telephone due to Covid lockdown. FindingsThe findings identified three major themes 1. Can't honestly call it pain, 2. Reassurance in normality, 3. Managing the unexpected. The use of the word pain to describe perineal sensations in postpartum was questioned by the participants, who used inner resources to deal with these sensations. Fostering self-confidence, having the possibility to explain the sensations and qualifying them as normal were some approaches women usedto manage their postpartum perineal sensations in a positive manner.