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Perineal Trauma is more Related With an Existentia ...
Perineal Trauma is more Related With an Existential Change than a Physical Modification itself: A Qualitative Study with Women Experiencing Humanized Birth - Luiz Gustavo Oliveira Brito, MD, PhD
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This study investigated how women experienced perineal trauma during a humanized birth and how it connected to the antenatal period, labor, and immediate postpartum period. The research was conducted through qualitative methods, with women being invited to participate through email or telephone. Snowball sampling was also used, where women referred other women who had undergone a similar experience. The deliveries were assisted by midwives and/or obstetricians following a humanized model of childbirth care. The study found that most women perceived perineal trauma as an existential transition, meaning that dealing with the perineal lesion in the postpartum period involved not just the physical injury but also the factors that caused it, such as gestation, birth, and the newborn. The study identified risk factors for perineal trauma, such as fetal macrosomia, instrumental delivery, prolonged second stage of labor, shoulder dystocia, nulliparity, and Asian ethnicity. The phenomenological analysis revealed themes such as satisfaction with labor experience influencing perception about the diagnosis and repair of perineal tears. The participants in the study were mostly well-educated and included healthcare professionals. They received specific preparation for humanized vaginal delivery and had support from partners, midwives, and doulas during labor and delivery. The interviews took place between 40 and 180 days after birth. Overall, the study highlights the existential impact of perineal trauma during birth and the need for multidisciplinary support and care during the postpartum period.
Keywords
perineal trauma
humanized birth
antenatal period
labor
immediate postpartum period
qualitative methods
risk factors
satisfaction with labor experience
diagnosis
postpartum care
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