Postnatal care and pathways for childbirth-related perineal trauma in England: A qualitative study of healthcare professionals' experiences and perspectives on future development

Amy Delicate¹, Sarah Hillman², Victoria Hodgetts Morton³, R Katie Morris³, Rebecca Man³, Laura Jones²; Chapter Collaborative Group

Collaborators, Affiliations

Collaborators

Chapter Collaborative Group:
Sara Webb⁴, John Maltby⁵, Nicola J Adderley⁶, Alice Sitch⁷, Olalekan Lee Aiyegbusi⁸, Marian Knight⁹, Krishnarajah Nirantharakumar¹⁰, Amie Wilson¹¹

Affiliations

¹ Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Murray Learning Centre, Edgbaston, Birmingham, B15 2TT, UK. Electronic address: a.r.delicate.1@bham.ac.uk.
² Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Murray Learning Centre, Edgbaston, Birmingham, B15 2TT, UK.
³ Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Murray Learning Centre, Edgbaston, Birmingham, B15 2TT, UK; Birmingham Women's Hospital, Birmingham, UK.
⁴ Royal College of Midwives, UK.
⁵ School of Psychology and Vision Sciences, University of Leicester, UK.
⁶ Department of Applied Health Research, University of Birmingham, UK; National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, UK.
⁷ Department of Applied Health Research, University of Birmingham, UK; NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, UK.
⁸ Centre for Patient Reported Outcomes Research (CPROR), Department of Applied Health Research, University of Birmingham, UK; NIHR Birmingham Biomedical Research Centre (BRC), University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, UK.
⁹ National Perinatal Epidemiology Unit, University of Oxford, UK.
¹⁰ Department of Applied Health Research, University of Birmingham, UK; NIHR Birmingham Biomedical Research Centre, UK.
¹¹ Department of Metabolism and Systems Science, University of Birmingham, UK.

PMID: 40975995
DOI: 10.1016/j.wombi.2025.102106

Free article

Postnatal care and pathways for childbirth-related perineal trauma in England: A qualitative study of healthcare professionals' experiences and perspectives on future development

Amy Delicate et al. Women Birth. 2025.

Free article

. 2025 Sep 19;38(6):102106.

doi: 10.1016/j.wombi.2025.102106. Online ahead of print.

Authors

Amy Delicate¹, Sarah Hillman², Victoria Hodgetts Morton³, R Katie Morris³, Rebecca Man³, Laura Jones²; Chapter Collaborative Group

Collaborators

Chapter Collaborative Group:
Sara Webb⁴, John Maltby⁵, Nicola J Adderley⁶, Alice Sitch⁷, Olalekan Lee Aiyegbusi⁸, Marian Knight⁹, Krishnarajah Nirantharakumar¹⁰, Amie Wilson¹¹

Affiliations

¹ Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Murray Learning Centre, Edgbaston, Birmingham, B15 2TT, UK. Electronic address: a.r.delicate.1@bham.ac.uk.
² Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Murray Learning Centre, Edgbaston, Birmingham, B15 2TT, UK.
³ Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Murray Learning Centre, Edgbaston, Birmingham, B15 2TT, UK; Birmingham Women's Hospital, Birmingham, UK.
⁴ Royal College of Midwives, UK.
⁵ School of Psychology and Vision Sciences, University of Leicester, UK.
⁶ Department of Applied Health Research, University of Birmingham, UK; National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, UK.
⁷ Department of Applied Health Research, University of Birmingham, UK; NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, UK.
⁸ Centre for Patient Reported Outcomes Research (CPROR), Department of Applied Health Research, University of Birmingham, UK; NIHR Birmingham Biomedical Research Centre (BRC), University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, UK.
⁹ National Perinatal Epidemiology Unit, University of Oxford, UK.
¹⁰ Department of Applied Health Research, University of Birmingham, UK; NIHR Birmingham Biomedical Research Centre, UK.
¹¹ Department of Metabolism and Systems Science, University of Birmingham, UK.

PMID: 40975995
DOI: 10.1016/j.wombi.2025.102106

Abstract

Background: Perineal trauma is a common outcome of vaginal birth, affecting 8/10 women in the UK. While many injuries heal without issue, complications such as infection, wound breakdown, and pain can impact maternal recovery, daily functioning, and wellbeing. Despite the burden of complications, postnatal wound management remain inconsistent, with limited evidence to guide optimal care.

Purpose: To examine the current postnatal care provision and care pathways used by healthcare professionals to address childbirth-related perineal trauma in England and explore their views on enhancing care.

Methods: The study was guided by an interpretive descriptive approach. Data was collected using semi-structured interviews with national health service healthcare professionals providing care to women following childbirth-related perineal trauma. Demographic data were analysed using descriptive statistics. Interview data were analysed by hybrid codebook thematic analysis.

Results: Healthcare professionals were interviewed in 2024 (N = 36). The current care provided for childbirth-related perineal trauma is described and represented visually, indicating that multiple care pathways and healthcare services are used. Healthcare professionals reported that improvements to childbirth-related perineal trauma care could come from enhancements to maternal awareness and information; healthcare professional education and training; and standardised evidence-based care pathways both for universal postnatal care and specialist childbirth-related perineal trauma care.

Conclusions: This study offers a unique insight postnatal care for women following childbirth-related perineal trauma in England, revealing a complex and regionally variable landscape. Healthcare professionals highlighted the need for greater standardisation and targeted improvements in care pathways to enhance outcomes for women.

Keywords: Care pathway; Childbirth related perineal trauma; Episiotomy; Healthcare professionals; Qualitative; Views and experiences.

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Declaration of Competing Interest There are no conflicts of interest to declare for any authors.

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Postnatal care and pathways for childbirth-related perineal trauma in England: A qualitative study of healthcare professionals' experiences and perspectives on future development

Collaborators

Affiliations

Postnatal care and pathways for childbirth-related perineal trauma in England: A qualitative study of healthcare professionals' experiences and perspectives on future development

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

LinkOut - more resources

Full Text Sources