Abstract
Objective:
The aim of the study is to explore midwives' experiences of and views upon 3rd and 4th degree perineal tears.
Method:
Focus group interviews with midwives from a university hospital. Qualitative analyse using principles from grounded theory.
Finds:
Several factors are considered by midwives as important for prevention of tears that can injure the anal sphincter. How the midwife deals with the physiological birth process is crucial. Challenges referred to, were that of caring for the baby's condition and the mother's perineum simultaneously, and that of speed controlling during birth of the head. An opinion was that the tears occurred with birth of the shoulders, and not only with birth of the head. The importance of patience during this part of the delivery was emphasized. Other essential points were mentioned, such as teamwork, an environment stimulating reflection, development and a highlighting of practical knowledge. This presupposes firm leadership promoting research and development.
Conclusion:
To prevent perineal tears, we have to recognize the complexity of the problem. Research and development in this field has to focus not only on technical aspects, but also on teamwork, the social setting, relations and reflection.