Vaginal Birth Related Perineal Traumas and the Importance of Experimental Trainings

J Clin Exp Invest 2020;11(1):em00733.

Article views: 402 Article downloads: 151


Download Full Text (PDF)


Perineal trauma caused by vaginal delivery is a problem that can occur in various ways from small lacerations to anal sphincter injury and one that negatively affects the quality of life of the woman. Specialists or midwives liable at perineal trauma repair are required to complete the intervention training for perineal trauma before their clinical practice and increase their skills with in-service training. The most important training materials used in the trainings organized for this purpose are the models consisting of materials that have very close properties to the actual tissues and organs. The aim of this study is to reveal the importance of skills training given to individuals responsible for repairing perineal traumas and to evaluate the effect of different application examples in this field.


perineal traumas, experimental trainings, animal and artificial tissue


  • Esteban BMM, Calvo JAS, Morcillo CT, Espeja JJD, Hinojosa JG, Goñi ÁZ. Retrospective case review of combined local mepivacaine and steroid injections into vaginal trigger points for the management of moderate-to-severe perineal pain after childbirth. Arc. of Gynec. Obs., 2019;299:501-5.
  • Aigmueller T, Bader W, Beilecke K, Elenskaia K, Frudinger A, Hanzal E. Kropshofer S. Management of 3rd and 4th Degree Perineal Tears after Vaginal Birth. German Guideline of the German Society of Gynecology and Obstetrics, 2015;137-44.
  • Wiseman O, Rafferty AM, Stockley J, Murrells T, Bick D. Infection and wound breakdown in spontaneous second‐degree perineal tears: An exploratory mixed methods study. Birth, 2019;1:80-9.
  • Masoumeh AK, Ahmad T, Zohreh S, Elaheh M. Perineal Trauma Incidence and its risk factors. J Obstet Gynaecol., 2019;39:206-11.
  • Kalichman L. Perineal massage to prevent perineal trauma in childbirth. Israel Medical Association Journal. 2008;10:531-3.
  • Bick DE, Kettle C, Macdonald S, Thomas PW, Hills RK, Ismail KM. Perineal assessment and repair longitudinal study (PEARLS): Protocol for a matched pair cluster trial. BMC Pregnancy Childbirth, 2010;1:10.
  • Begley C, Guilliland K, Dixon L, Reilly M, Keegan C, Mc Cann C, Smith V. A qualitative exploration of techniques used by expert midwives to preserve the perineum intact. Women and Birth, 2019;31:87-9
  • Brunstad A, Nilsen ABV, Aasheim V. Delivery Practices and Perineal Tears: Midwives’ Experiences, 2015.
  • Thiessen K, Nickel N, Prior H, Banerjee A, Morris M, Robinson K. Maternity Outcomes in Manitoba Women: A Comparison between Midwifery-led Care and Physician-led Care at Birth. Birth, 2016;43:108-14.
  • Adler B, Bodner A, Oliver K, Julia G, Peter H, Klaus B. A ten-year study of midwife-led care at an Austrian tertiary care center: a retrospective analysis with special consideration of perineal trauma. BMC Pregnancy and Childbirth, 2017;17:2-7.
  • O’Kelly SM, Moore ZE. Antenatal Maternal Education For İmproving Postnatal Perineal Healing for Women who have birthed in Hospital Setting. Cochrane Database of Systematic Reviews, 2017;12.
  • Doo DW, Powell M, Novetsky A, Sheeder J, Guntupalli SR. Preparedness of Ob/Gyn residents for fellowship training in gynecologic oncology. Gynecol Oncol Case Rep., 2015;12:55-60.
  • Şendir M. Use of Simulation in Women Health Nursing Education. F. N. Nurs. J., 2013;21:2147-4923.
  • Akalını A. Şahin S. Theories in Simulation-Based Nursing Education. Journal of Health Science and Profession, 2019;1:135-41.
  • Illston JD, Ballard AC, Ellington DR, et al. Modified Beef Tongue Model for Fourth-Degree Laceration Repair Simulation. Obstet Gynecol., 2017;129:491-6.
  • Sparks RA, Beesley AD, Jones AD. The “sponge perineum:” an innovative method of teaching fourth-degree obstetric perineal laceration repair to family medicine residents. Fam Med., 2006;38:542.
  • Ciesielski P, Małgorzata K, Paweł D. New porcine model of perineal tear and its utility in physicians’ training on the reconstruction of 3rd and 4th degree perineal tear during vaginal delivery. Ginekol Pol., 2018;10:558-62.
  • Guler H, Cetin P, Yurtsal Z.B, Cesur B, Bekar M, Uçar, et al. Effect of episiotomy training with beef tongue and sponge simulators on the self-confidence building of midwifery students. Nurse Education in Practice. 2018;30;1-6.
  • Goudie C, Shanahan J, Gill A, Murphy D, Dubrowski A. Investigating the efficacy of anatomical silicone models developed from a 3D printed mold for perineal repair suturing simulation. Cureus, 2018;10:8.
  • Berman B. 3-D Printing: The New Industrial Revolution. Business Horizons, 2012;55:155-62.
  • Bartellas MP. Three-dimensional printing and medical education: a narrative review of the literature. University of Ottawa Journal of Medicine, 2016;6:38-43.
  • Lavesson T, Griph I. D, Skärvad A, Karlsson AS, Nilsson HB, Steinvall M, Haadem K. A perineal protection device designed to protect the perineum during labor: a multicenter randomized controlled trial. European Journal of Obstetrics & Gynecology and Reproductive Biology, 181(2014):10-4.
  • Silf K, Woodhead N, Kelly J, Fryer A, Kettle C, Ismail KMK. Evaluation of accuracy of mediolateral episiotomy incisions using a training model. Midwifery, 2015;31:197-200.


Erbaba H, Ciesielski P. Vaginal Birth Related Perineal Traumas and the Importance of Experimental Trainings. J Clin Exp Invest. 2020;11(1):em00733.