Minimizing Genital Tract Trauma and Related Pain Following Spontaneous Vaginal Birth

Leah L. Albers, CNM, DrPH; Noelle Borders, CNM, MSN

J Midwifery Womens Health. 2007;52(3):246-253.

Care After Childbirth

The extent and complexity of genital tract trauma is directly related to the amount of suturing required and to subsequent perineal pain. Thus, more trauma equals greater morbidity after birth.^[9,10,11] Although some clinicians have adopted the practice of not suturing lacerations that exclude the anal sphincter and rectum, this approach has not been systematically evaluated in studies of adequate size and with sufficient long-term follow-up.^[33] The existing clinical standard favors the suturing of lacerations, other than those that are small and shallow, to promote healing and restore tissue function. Thus, the methods of suturing and the materials used for repair of lacerations, as well as pharmacologic and nonpharmacologic methods of pain management, may have an effect on perineal pain.

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