Women’s experiences of postnatal care in England following childbirth-related perineal trauma and considerations for developing an optimal care pathway: a qualitative study

BACKGROUND: Childbirth-related perineal trauma (CRPT) affects around 80% of UK women during vaginal birth. The effects of CRPT can be physical and psychological and women report a need for better support as they recover. AIM: To explore women's experiences of postnatal care following CRPT in England and identify considerations for developing an optimised care pathway to improve maternal experience and outcomes. METHODS: A qualitative study guided by an interpretive descriptive approach. Semi-structured interviews and focus groups with women who gave birth using the NHS in the last 12 months and experienced CRPT. Qualitative data were analysed using inductive codebook thematic analysis. FINDINGS: The sample (N = 29) of women were all resident in England; had an average age of 30 years (range 21-39 years); and one fifth had a first language other than English (n = 6, 20.9%). Women reported that current postnatal care did not always meet their needs regarding recovery following CRPT. Suggested enhancements for CRPT care comprised of standardised postnatal maternity care; responsive and reassuring healthcare professionals; and enabling women to be prepared and informed. DISCUSSION: Developing the CRPT care pathway could validate the significance of what women experience and through provision of enhanced, individualised care, could improve maternal experience and health outcomes. CONCLUSION: CRPT affects most women during vaginal birth and whilst many recover without issues, some need additional healthcare. Current postnatal care has limitations for addressing physical and psychological CRPT health concerns. Enhancements to care for inclusion within standardised care pathway are identified.