A pragmatic tool for the measurement of perineal tears

Perineal trauma following childbirth affects around 70% of women (Greenshields and Hulme, 1993). The two main sources of trauma are due equally to either episiotomy (surgical incision of the perineum) or to a spontaneously occurring tear. Perineal tears vary in size and are graded from first degree (the most minor) to fourth degree (most severe). First, third and fourth degree tears are all clearly defined by the anatomical structures involved and clearly describe the extent of the trauma incurred. However, second-degree tears can vary widely in size and are often given the subjective descriptions of small, medium and large. Approximately 25–35% of all childbearing women sustain a second-degree perineal tear during childbirth but research and audit of the most appropriate aftercare for the wound has been restricted by the inability to provide a more objective measurement of second-degree tears. The Birmingham Perineal Research Evaluation Group has developed a tool to provide an objective measurement of se...