Optimizing and enhancing perineal repair knowledge and teaching among obstetricians and midwives: A prospective three-site study.

OBJECTIVES

Perineal assessment and repair are fundamental to providing quality obstetric and midwifery care to women. Up to 80% of women sustain perineal trauma during vaginal delivery, and 70% require repair. This study aimed to establish baseline perineal anatomy knowledge, training exposure, and experience, and to assess whether ongoing training is needed to strengthen perineal repair education and skills.

METHODS

This is a prospective multicenter observational study. Obstetricians and midwives actively involved in perineal repair were recruited in three maternity units between April and July 2024. A pre-survey was completed. A teaching intervention was delivered to participants. After the teaching intervention, a post-survey was completed. The sample size was appropriately powered and the data were analyzed accordingly.

RESULTS

During the study period, 89 clinicians completed the pre-survey, and 72 attended the training initiative and completed the post-survey. A total of 84.3% of clinicians had prior training in assessing perineal injury, and 83.1% had some form of practical training in perineal repair. Only 75.3% had received training on assessing for obstetric anal sphincter injury. A total of 88.8% of clinicians felt confident performing an episiotomy, and only 69.7% felt confident in repairing an episiotomy. After the teaching intervention, the post-survey responses highlighted significant improvement in anatomical knowledge among clinicians conducting perineal repair (P = 0.0078).

CONCLUSIONS

Ongoing learning is necessary for clinicians who are actively completing perineal repair. It results in increased knowledge, which should impact the quality of care for women requiring perineal repair.