Midwifery management of second-degree perineal tears in New Zealand: A cross-sectional survey of practice.
Women Birth
; 31(5): 422-429, 2018 Oct.
Article
en En
| MEDLINE
| ID: mdl-29289503
ABSTRACT
BACKGROUND:
Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives' perineal practice.AIM:
The aim of this study was to identify how midwives managed the last second-degree perineal tear they treated and the level to which their practice reflects National Institute for Health and Care Excellence guidelines.METHODS:
An (anonymous) online survey was conducted over a six-week period in 2013. New Zealand midwives who self-identified as currently practising perineal management and could recall management of the last second-degree tear they treated were included in the analysis.FINDINGS:
Of those invited, 645 (57.1% self-employed, 42.9% employed) were eligible and completed surveys. Self-employed midwives reported greater confidence (88.0% vs 74.4%, p<0.001) and more recent experience (85.1% vs 57.4%, p<0.001) with perineal repair than employed midwives. Midwives who left the last second-degree tear unsutured (7.3%) were more likely to report low confidence (48.9% vs 15.4%, p<0.001) and less recent experience with repair (53.2% vs 24.7%, p<0.001), and were less likely to report a digital-rectal examination (10.6% vs 49.0%, p<0.001), compared to midwives who sutured. Care consistent with evidence-based guidelines (performing a digital-rectal examination, 59.4% vs 49.3% p=0.005; optimal suturing techniques, 62.2% vs 48.7%, p=0.001) was associated with recent perineal education.CONCLUSIONS:
Midwives' management of the last second-degree perineal tear is variable and influenced by factors including employment status, experience, confidence, and perineal education. There is potential for improvement in midwives' management through increased uptake of evidence-based guidelines and through ongoing education.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Perineo
/
Competencia Profesional
/
Laceraciones
/
Parto Obstétrico
/
Complicaciones del Trabajo de Parto
/
Partería
Tipo de estudio:
Guideline
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Women Birth
Asunto de la revista:
ENFERMAGEM
/
OBSTETRICIA
Año:
2018
Tipo del documento:
Article