A discussion of some of the literature relating to history, repair and consequences of perineal trauma.

OBJECTIVE

to review the key literature on perineal trauma, discussing the historical background, the materials and techniques used, the possible consequences of repair and assess midwives' current and potential contribution to perineal repair.

LITERATURE SEARCH

the literature was identified using conventional search techniques: Midwifery Information Resource Service (MIDIRS) and the Cochrane Pregnancy and Childbirth Database. Keywords used during the search were: episiotomy, perineal trauma and adverse effects. Associated keywords words were sexuality, pain and psychology.

KEY CONCLUSIONS

current practice in the UK is inconsistent with the available evidence, perineal trauma can cause long term problems, and midwives are in an ideal position to take forward evidence-based perineal repair.

IMPLICATIONS FOR PRACTICE

midwives need adequate education and training in perineal repair but are likely to be more effective in performing the repair. Systematic evaluation of the impact of extending midwives' influence in this area is essential.