Postnatal care and pathways for childbirth-related perineal trauma in England: A qualitative study of healthcare professionals' experiences and perspectives on future development

Background: Perineal trauma is a common outcome of vaginal birth, affecting 8/10 women in the UK. While many injuries heal without issue, complications such as infection, wound breakdown, and pain can impact maternal recovery, daily functioning, and wellbeing. Despite the burden of complications, postnatal wound management remain inconsistent, with limited evidence to guide optimal care. Purpose: To examine the current postnatal care provision and care pathways used by healthcare professionals to address childbirth-related perineal trauma in England and explore their views on enhancing care. Methods: The study was guided by an interpretive descriptive approach. Data was collected using semi-structured interviews with national health service healthcare professionals providing care to women following childbirth-related perineal trauma. Demographic data were analysed using descriptive statistics. Interview data were analysed by hybrid codebook thematic analysis. Results: Healthcare professionals were interviewed in 2024 (N = 36). The current care provided for childbirth-related perineal trauma is described and represented visually, indicating that multiple care pathways and healthcare services are used. Healthcare professionals reported that improvements to childbirth-related perineal trauma care could come from enhancements to maternal awareness and information; healthcare professional education and training; and standardised evidence-based care pathways both for universal postnatal care and specialist childbirth-related perineal trauma care. Conclusions: This study offers a unique insight postnatal care for women following childbirth-related perineal trauma in England, revealing a complex and regionally variable landscape. Healthcare professionals highlighted the need for greater standardisation and targeted improvements in care pathways to enhance outcomes for women.<p></p>