Perineal wound assessment and repair education for midwifery students: a multi-methods study

Background: Perineal trauma is a common injury sustained during childbirth that, if not managed appropriately, can lead to significant physical and psychological morbidities. Knowledge and skills gaps for perineal wound trauma assessment and repair exist among health professionals and students. These deficits can be effectively addressed through structured education and training. Currently, there is a lack of research that has evaluated perineal trauma education and training in undergraduate midwifery programs.

Objective: To evaluate the effectiveness of a perineal wound assessment and repair workshop for midwifery students in their final year of study.

Methods: A multi-method study design was used to measure knowledge, self-confidence and skills of a midwifery student cohort, before and after the implementation of an educational workshop on perineal wound assessment and repair. Convenience sampling was used to recruit 65 midwifery students in their final year of a Bachelor of Midwifery program at an Australian university. Ethical approval: Approval was obtained from the Human Research Ethics Committee (HREC) of the University of South Australia (0000036768).

Results: Post-workshop mean test scores for a multiple-choice questionnaire were statistically significant (p < .0001) indicating an overall improvement in students’ knowledge in perineal wound assessment and repair. Students’ self-assessment on their knowledge, confidence and skills in anatomy and physiology, assessment and recognition of perineal trauma and repair, were statistically significantly higher in all areas (p < .0001) after the workshop. Midwifery students’ reflective journals were analysed verbatim and five main themes were identified. Twelve sub-themes were determined that gave a deeper insight into students’ learning and support the main findings of this study.

Conclusion: This study showed that the inclusion of a perineal wound assessment and repair workshop in an undergraduate midwifery curriculum improved the knowledge and confidence of midwifery students in the management of childbirth-related perineal trauma.

Implications: While this study is limited in scope it demonstrates the clear need to ensure perineal wound education is provided in undergraduate midwifery programs. Further research that focuses on student midwives’ knowledge and confidence after attending perineal wound education over a longer period is recommended.