The knowledge, practice and opinion of midwives' in the UK on their training in obstetric perineal repair.

Abstract

To investigate the knowledge and practice of perineal repair by midwives' in the UK, as well as their perception of the adequacy of their training. An anonymous structured questionnaire survey was conducted. Standard statistical comparative analysis was performed between groups. Significant differences were quantified by calculating odds ratios and 95% confidence intervals. P < 0.05 was considered significant. Analysis of 592 responses revealed that midwives who believed that they had adequate training were ten times more likely to report that they have an adequate knowledge of pelvic floor anatomy (OR 9.8, 95% CI 6.4-14.9, P < 0.001), six times more likely to be aware of recommended techniques of perineal repair (OR 6.1, 95% CI 3.8-9.7, P < 0.001) and 16 times more likely to feel competent to perform a repair (OR 16.1, 95% CI 9.3-27.2, P < 0.001). Midwives who had formal hands-on perineal repair training were four times more likely to report that they have an adequate knowledge of pelvic floor anatomy (OR 4.1, 95% CI 2.8-5.8, P < 0.001) and four times more likely to feel competent enough to perform a repair (OR 3.6 95% CI 2.4-4.9, P < 0.001). The majority of midwives in the study sample report that they were unable to identify key perineal anatomy and believed that their pre-qualification training on perineal repair was inadequate. They also believed that midwives should routinely repair simple second-degree perineal tears.