Department of Midwifery, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Universite Campus Nord, Ecole de Maïeutique, Chemin des Bourrely, 51 BVD Pierre Dramard, Marseille 13015, France.
Department of Nursing and Community Health, Room A405, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, Scotland G4 0BA, United Kingdom.
Midwifery. 2024 Feb;129:103909. doi: 10.1016/j.midw.2023.103909. Epub 2023 Dec 14.
Postpartum perineal pain is a frequent symptom (90%) with consequences on postnatal health regardless of whether the perineum remains intact. The impact of that pain on both short and long-term health has been studied and literature suggests midwives have a role to play in addressing this issue. However, the determinants of perineal pain when no lesions are identified are under researched and there is little understanding of women's views on this topic.
The aim of the study was to gain an understanding of postpartum perineal pain when the perineum is considered to be intact. The objectives were •To gain an understanding of postpartum pain and its consequences on health and well-being •To explore women's views and understanding of perineal pain postpartum •To gain an understanding of the determinants of postpartum perineal pain when no anatomic lesion is diagnosed.
A Gadamerian hermeneutic approach was used to achieve a shared understanding of the issue. Participants were recruited from two maternity hospitals in the French area of Vaucluse. All women aged 18 to 45 years old, having given birth vaginally to a single live child and diagnosed with an intact perineum, were invited to participate in face-to-face interviews. Eleven participants were interviewed once, six of whom agreed to a second interview which took place over the telephone due to Covid lockdown.
The findings identified three major themes 1. Can't honestly call it pain, 2. Reassurance in normality, 3. Managing the unexpected. The use of the word pain to describe perineal sensations in postpartum was questioned by the participants, who used inner resources to deal with these sensations. Fostering self-confidence, having the possibility to explain the sensations and qualifying them as normal were some approaches women usedto manage their postpartum perineal sensations in a positive manner.
产后会阴疼痛是一种常见症状（90%），无论会阴是否完整，都会对产后健康产生影响。人们已经研究了这种疼痛对短期和长期健康的影响，并且文献表明助产士在解决这个问题上可以发挥作用。然而，在没有发现损伤的情况下，会阴疼痛的决定因素研究不足，并且对女性对这个问题的看法知之甚少。
本研究旨在了解会阴被认为完整时的产后会阴疼痛。目的是：
了解产后疼痛及其对健康和幸福的影响。
探讨女性对产后会阴疼痛的看法和理解。
了解在未诊断出解剖损伤时产后会阴疼痛的决定因素。
采用伽达默尔诠释学方法，对这一问题达成共识。参与者是从法国沃克吕兹地区的两家妇产医院招募的。所有年龄在 18 至 45 岁之间、经阴道分娩单活婴且会阴完整的妇女均被邀请参加面对面访谈。11 名参与者接受了一次访谈，其中 6 名因新冠疫情封锁而同意进行第二次电话访谈。
研究结果确定了三个主要主题：1. 不能诚实地称之为疼痛，2. 正常状态的安心，3. 应对意外。参与者对用“疼痛”一词来描述产后会阴的感觉提出了质疑，她们利用内在资源来应对这些感觉。培养自信、有解释感觉的可能性并将其定性为正常，是女性以积极的方式管理产后会阴感觉的一些方法。
