Women’s experience with a first- and second-degree perineal tear and episiotomy – a qualitative study

Perineal tears are associated with both physical- and psychological complications, and studies have found that women’s individual experience of the pain from the tear does not necessarily reflect the extent and severity of the tear. Women seem to experience a lack of consistency and sufficient follow up in the post-partum period related to perineal trauma. The aim of this study was to explore women’s experiences with first- and second- degree perineal tears and episiotomy in the post-partum period in an outpatient perineal clinic at a tertiary hospital in Norway. We conducted a qualitative study using individual semi-structured interviews, with women experiencing a follow-up of their perineal tear from an outpatient clinic. Participants were recruited from one tertiary hospital in Norway, and we conducted 18 individual interviews. All interviews were audio recorded, transcribed verbatim and analysed using systematic text condensation as described by Malterud. Three code groups and one overarching theme were identified. The overarching theme was that the women experienced a feeling of being left alone with the responsibility of both their physical and psychological needs regarding their perineal tear. The women described (I) lack of affirmation and emotional support, (II) lack of guidance on normal processes and (III) lack of systematic follow up of perineal tears. The women in this study felt they were left alone with their perineal tear and did not receive support nor recognition from healthcare professionals regarding the challenges they faced. The physical and psychological consequences women experienced related to their perineal tear highlight the need for a more systematically and individually tailored care for women in the post-partum period, from both midwives and doctors.