Postpartum care of the perineum

Authors

  • Myra Fitzpatrick MRCOG,

    Professor of Obstetrics and Gynaecology, Corresponding author
    1. National Maternity Hospital Department of Obstetrics and Gynaecology Holles Street, Dublin 2 Republic of Ireland
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  • Colm O'Herlihy FRCOG

    Professor of Obstetrics and Gynaecology
    1. National Maternity Hospital Dublin, Republic of Ireland
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National Maternity Hospital Department of Obstetrics and Gynaecology Holles Street, Dublin 2 Republic of Ireland Email: myrafitzpatrick@hotmail.com

Abstract

Key content

  • Vaginal birth is traumatic to the pelvic floor and perineum.
  • Faecal incontinence, perineal pain, urinary incontinence and dyspareunia can all be long-term effects of such damage.
  • Recognition and management of perineal trauma postpartum is vital.
  • Women rarely volunteer information regarding faecal incontinence and dyspareunia.
  • A dedicated pelvic floor clinic may be the most appropriate setting in which to care for women who are affected.

Learning objectives

  • To learn about the guidelines in place for the repair of perineal trauma following delivery.
  • To recognise that anal sphincter damage may require follow-up and appropriate investigation.
  • To learn that direct questioning of women about dyspareunia and faecal incontinence is necessary to elicit information.

Ethical issues

  • Is it the responsibility of women to present with their problems or should nursing and medical staff look for them?
  • Financial constraints inappropriately limit the provision of small, highly focused clinics.

Please cite this article as: Fitzpatrick M, O'Herlihy C, Postpartum care of the perineum. The Obstetrician & Gynaecologist 2007;9:164–170.

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