Postnatal Perineal Wound Assessment

NCT06551493 | Recruiting

• 1 other identifier: 334946
• Study Type: observational
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

Around 85% of women who give birth vaginally experience a perineal wound, which could be a tear or an incision between the vaginal opening and the anus. Despite that, there is often insufficient exploration of how postnatal perineal wound assessment is conducted in healthcare research. Clinical guidelines from the National Institute for Health and Care Excellence (NICE) touch on the typical signs of wound infection but do not offer detailed guidance on the execution of perineal assessment. Existing research evidence is mostly focused on long-term complications, management of perineal trauma immediately after birth or severe perineal trauma. The limited research on perineal wound care highlights how poor communication and information provision harm women at a physical and psychological level, negatively affecting daily tasks such as caring for their newborns. Although there have been few studies examining women's or midwives' perspectives on perineal wound assessment in the context of uncomplicated wounds, their perspectives have never been jointly investigated to produce a comprehensive overview. Moreover, no research has had a clinical focus, investigating how the assessment is conducted in practice and what informs this practice, except from women's reports of perceived sub-standard care received. Therefore, this proposed research is clinically grounded and aims to explore women's and midwives' perspectives on postnatal perineal wound assessment. This is needed to identify evidence-based practices, or lack thereof, in order to determine ways in which the experience can be improved for women and to have a more positive impact on their wellbeing. Eight to ten pairs of midwives-women will be first observed whilst the routine assessment is conducted to understand what happens during this episode of care, and then they will be separately interviewed within a few days to gather further understanding. Recruitment will be in a single centre, which is a tertiary unit in the UK.

Conditions

Perineum; Wound

Outcome Measures

Primary Outcomes (2)

• Survey. How midwives conduct postnatal perineal wound assessment step-by-step.

  10 days postnatal

• Survey women's experiences of postnatal perineal wound assessment, i.e. emotional or physical discomfort.

  10 days postnatal

Study Arms (2)

Postnatal women

Other: Observation of postnatal wound assessment; Other: Interview

Registered midwives

Other: Observation of postnatal wound assessment; Other: Interview

Interventions

Observation of postnatal wound assessment OTHER

Observation of postnatal wound assessment

Postnatal women; Registered midwives

Interview OTHER

Interview to elicit individual perspectives of wound assessment

Postnatal women; Registered midwives

Eligibility Criteria

• Age: 18 Years - 100 Years
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Midwives and postnatal women

You may qualify if:

• Midwives:
• NMC Registered midwives
• Working in the NHS
• Working in the community or postnatal ward
• Who assess perineal wounds
• Women:
• Postnatal women who had a vaginal birth within the last ten days and had an uncomplicated perineal tear (first, second-degree or episiotomy).
• Had a healthy newborn (for example, the newborn is not currently admitted to newborn intensive care or the woman did not have a stillbirth)
• Located in the community or in hospital being cared for by midwives, within ten days postpartum when postnatal perineal wound assessment occurs.
• Over the age of 18, who can consent to participation
• English-speaking

You may not qualify if:

• Midwives:
• Non-registered midwives and those working outside the NHS
• Who do not perform postnatal perineal wound assessment due to clinical settings or task restrictions.
• Women:
• Who had a cesarean section
• Who had a stillbirth or fetal/neonatal complications
• Who had a vaginal birth but sustained severe perineal tears (third or fourth-degree tears)
• Who have not received NHS care or are outside standard postnatal locations
• Who are over 10 days postpartum at the time of perineal wound assessment
• Who are below the age of 18
• Non-English-speaking women

Sponsors & Collaborators

• Oxford Brookes University: lead

Study Sites (1)

Oxford University Hospital NHS Foundation Trust

Oxford, Oxfordshire, OX39DU, United Kingdom

RECRUITING

MeSH Terms

Conditions

Wounds and Injuries

Interventions

Interviews as Topic

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Central Study Contacts

Giada Giusmin

CONTACT

01865603166; ggiusmin@brookes.ac.uk

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Senior Lecturer in Midwifery

Study Record Dates

• First Submitted: August 8, 2024
• First Posted: August 13, 2024
• Study Start: November 20, 2024
• Primary Completion: August 1, 2025
• Study Completion: August 1, 2025
• Last Updated: August 8, 2025

Record last verified: 2024-08

Locations

GB (1)