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The effects of perineal trauma on immediate self-reported birth experience in first-time mothers
Journal of Psychosomatic Obstetrics & Gynecology ( IF 3.1 ) Pub Date : 2021-05-19 , DOI: 10.1080/0167482x.2021.1923689
Rebecca Molyneux 1 , Gillian Fowler 2 , Pauline Slade 1
Affiliation  

Abstract

Introduction

Childbirth can sometimes be stressful or traumatic, and previous research has considered how birth complications and interventions may contribute to a negative birth experience. One of the most frequent complications during birth is trauma to the perineum. The aim of this study was to investigate whether different levels of perineal trauma were associated with differences in women’s evaluation of their birth experience.

Materials and methods

As part of a longitudinal cohort study, the self-reported birth experiences of 202 primiparous women were compared based on the degree of perineal trauma they had experienced. Women who had given birth for the first time, vaginally and within the last 48 h in a large tertiary maternity unit in England were invited to take part. Data were collected from their hospital records with their consent and using the Childbirth Experience Questionnaire (CEQ), Experience of Birth Scale (EBS) and a perineal pain Visual Analogue Scale (VAS).

Results

Women with an obstetric anal sphincter injury (OASI) or episiotomy reported a more negative overall birth experience and perceived themselves as having less ability to give birth compared to those with a 1st/2nd degree sutured tear. Those with an episiotomy also reported feeling less involved in decision making processes during their birth. Significant differences remained between the OASI and 1st/2nd degree tear groups when controlling for factors known to affect birth experience, highlighting severe perineal trauma as a potential contributor to more negative birth experience.

Conclusions

Perineal trauma may affect a woman’s birth experience. Experiencing an episiotomy should not be overlooked as a potential contributor, especially during instrumental birth and in the absence of involved decision making. Further research is needed to disentangle the effects of episiotomy on birth experience, to explore the care needs of women with different degrees of perineal trauma and to explore how a negative birth experience may contribute to poor psychological health in the longer term.



中文翻译:

会阴创伤对初次母亲立即自我报告的分娩经历的影响

摘要

介绍

分娩有时会带来压力或创伤,之前的研究已经考虑过分娩并发症和干预措施如何导致消极的分娩经历。分娩过程中最常见的并发症之一是会阴损伤。本研究的目的是调查不同程度的会阴创伤是否与女性对其分娩经历的评估差异有关。

材料和方法

作为纵向队列研究的一部分,根据她们经历的会阴创伤程度比较了 202 名初产女性的自我报告分娩经历。邀请在英格兰的一个大型三级产科中第一次分娩、阴道分娩和过去 48 小时内分娩的妇女参加。数据是在他们同意的情况下从他们的医院记录中收集的,并使用分娩经验问卷 (CEQ)、出生经验量表 (EBS) 和会阴疼痛视觉模拟量表 (VAS)。

结果

患有产科肛门括约肌损伤 (OASI) 或会阴切开术的女性报告了更负面的整体分娩经历,并认为与 1/2 度缝合撕裂的女性相比,她们的分娩能力较差。那些接受会阴切开术的人还报告说,他们在出生时感觉较少参与决策过程。在控制已知会影响分娩经历的因素时,OASI 和 1 度/2 度撕裂组之间仍然存在显着差异,强调严重的会阴创伤是导致更负面分娩经历的潜在因素。

结论

会阴部创伤可能会影响女性的分娩经历。不应忽视会阴切开术作为潜在的贡献者,尤其是在器械分娩和没有相关决策的情况下。需要进一步的研究来解开会阴切开术对分娩经历的影响,探索有不同程度会阴创伤的女性的护理需求,并探索消极的分娩经历如何导致长期的心理健康不佳。

更新日期:2021-05-19
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