A doctor putting a stethoscope to a newborn baby's chest

Childbirth for most women is a joyous event, but it is well documented that pain and discomfort due to bruising, swelling and stitches in and around the birth canal (known as perineal trauma) can significantly blight the experiences of motherhood. The number of women who experience this trauma, particularly severe trauma varies between maternity units and geographical areas across the UK. It is possible that these differences may relate to what midwives are currently doing in practice at the moment of birth.

The study aimed to provide a better understanding of perineal practice undertaken by midwives at the time of birth across the UK. The specific objectives were to:

  • Obtain hospital policies from maternity units across the UK, via the Heads of Midwifery;
  • Map perineal practice in hospitals across the UK through a survey of midwives accessed through the Supervisors of Midwives network, and
  • Gain a more in-depth understanding of midwives’ individual practice, beliefs and attitudes towards perineal care at the time of birth.

Ethical approval

Ethical approval was gained through Bournemouth University’s ethics committee.


In order to meet the objectives, three methods were used to collect data for this study. They comprised the collection of written NHS policy documentation, an anonymous online survey to gather information and focus group interviews. These were each completed and the study collected information from across the four countries of the UK.


Findings have been disseminated at a number of conferences:

  • 5th European Midwives Association Education Conference – London, December 2016, oral presentation
  • 12th International Normal Birth Conference – Cumbria, October 2017
  • Royal College of Midwives annual conference – Manchester, October 2017, oral presentation
  • International Confederation Midwives (ICM) Conference, Toronto, Canada, June 2017 - poster presentation
  • International Normal Labour and Birth Conference, Cumbria, June 2019 - poster presentation and Pecha Kucha presentation

Next steps

The next phase of the research will explore midwives' experiences when women sustain severe perineal tears.

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