The role of midwives in shaping postnatal care after perineal trauma: Women's perspectives on midwifery support - A qualitative study.

BACKGROUND

Postnatal care following perineal trauma is crucial, yet many women report unmet physical, emotional, and educational needs during recovery.

AIM: To explore women's experiences and perceptions of postnatal care after perineal trauma, with a focus on midwifery support.

DESIGN

This qualitative study was part of the Yoni Study, which assessed effectiveness of a perineal pain management guideline.

METHODS

The study was conducted in a large tertiary hospital in Australia, and recruited women who sustained perineal trauma after vaginal birth. Participants completed surveys at 24-48 h, 7 days, and 12 weeks postnatal. Free text comments were analysed using reflexive thematic analysis, with a focus on negative comments, revealing 88 coding instances that highlighted unmet needs.

RESULTS

The analysis revealed an overarching theme of unmet needs and expectations, underpinned by five interrelated subthemes: lack of postnatal support and education, overlooked physical recovery needs, emotional isolation, judgment around newborn care, and inconsistent advice. While many women reported positive care experiences, systemic constraints such as early discharge and understaffing limited personalised support, intensifying anxiety and reducing confidence in self-care.

CONCLUSION

Addressing systemic limitations and enhancing personalised midwifery support are critical for improving postnatal outcomes. Proactive, culturally sensitive education and emotional care are essential to meet the diverse needs of women recovering from perineal trauma.