Women's experiences of perineal pain during the immediate postnatal period: a cross-sectional study in Brazil

Abstract

Objective: To identify the severity and prevalence of perineal pain during the post partum in-patient period and associated obstetric, maternal and newborn baby factors following birth.

Design: Cross-sectional study.

Setting: A postnatal ward of a hospital in São Paulo, Brazil.

Participants: 303 Postnatal women.

Measurements: Interviews and perineal assessment were conducted to evaluate the perineal outcomes (trauma and pain). Data on maternal characteristics and infant anthropometric variables were collected.

Results: Among all women, 80.5% had perineal trauma (60.7% had episiotomy) and 18.5% reported perineal pain. The mean pain intensity score was 4.8 ± 1.9 on the visual analogue scale. Only maternal age (ORa = 1.08) and performance of episiotomy (ORa = 3.80) remained as independent predictors of perineal pain in the final logistic regression model.

Key conclusions: Perineal pain in the immediate postnatal period was highly associated with older maternal age and use of episiotomy, although the overall reporting of perineal pain was low.

Implications for practice: Perineal pain following vaginal birth is associated with interventions during labour as well as with maternal characteristics. Despite the negative impact on a woman's daily activities, perineal pain following birth is neglected by care givers and usually not reported by women who may consider it to be a normal outcome of giving birth. Care providers need to ensure all interventions during labour and birth are informed by evidence of benefit and that barriers to implementation of evidence are addressed. Further work is needed to obtain the views of women in Brazil on their health and well-being following birth.