The bottom line: Care of the perineum must be improved

Abstract

In the UK, around 750000 women will give birth each year. Of these, 525000 (approximately 70%) will sustain perineal trauma and will require stitches (Kettle and Johanson, 2000a). It is generally accepted that most of these women will experience perineal pain immediately after delivery and in the short term. What is not generally known is that long-term perineal pain and dyspareunia can affect around 20% or 120750 women who have sustained perineal trauma a year (Kettle and Johanson, 2000a). This may impact on a woman's self-image, her sexuality, her relationship with her baby and can ultimately adversely affect the couple's relationship. This article will focus on this ill-researched but highly pertinent issue of women's health. It includes possible methods of preventing perineal trauma, the continuing debate concerning episiotomy versus spontaneous tearing and issues surrounding repair of the perineum. A future article will discuss the treatment of perineal pain and discomfort and practical help for women suffering dyspareunia.