Prevention of Perineal Trauma

Intrapartum perineal and pelvic floor trauma can be associated with considerable short and long-term morbidity. Perineal lacerations and episiotomies can be painful, incur blood loss, and may become infected; rarely fistulae may occur. Other long-term complications such as anal incontinence and pelvic organ prolapse can profoundly affect women’s quality of life. Anal incontinence may occur after an obstetric anal sphincter injury (OASI) and pelvic organ prolapse after levator ani avulsion. Preventing intrapartum perineal trauma and pelvic floor trauma in even a modest proportion of births would benefit large numbers of women. Health care professionals should implement effective prevention strategies to mitigate this risk.