Friday, July 13, 2007
This presentation is part of : Strategies in Women's Health
Nursing Management of Postpartum Perineal Pain: Evidence for Practice!
Angelina Arcamone, DNSc, RN, School of Nursing, Thomas Jefferson University, Philadelphia, PA, USA
Learning Objective #1: Discuss the current evidence that exists for nursing interventions for the management of postpartum perineal pain.
Learning Objective #2: Discuss how prenatal education can help a postpartum patient mangage perienal pain.

Perineal discomfort is a common sequela of vaginal birth and, in the postpartum period, it is a major complaint of many women (Fishbein & Burggraf, 1998; Macarthur & Macarthur, 2004).  It is associated with many factors, including assisted deliveries, length of second stage, size of baby, maternal parity, tears or lacerations of the vagina or rectum, and, sutures following episiotomy repair (Khan, 2006). However, many of the nursing interventions used to manage postpartum perineal pain are not based on evidence.  Therefore, the purpose of this study was to describe and compare perineal pain two weeks after vaginal birth in primiparous women who attended prepared childbirth classes and women who did not attend prepared childbirth classes. 

         A convenience sample of primiparous women (N = 158) who gave birth vaginally to healthy newborns was recruited for this descriptive comparative posttest only design. Women who attended prepared childbirth classes (n = 105) and women who did not attend prepared childbirth classes (n = 53) responded to the Short-Form McGill Pain Questionnaire (SF-MPQ) (Melzack, 1987) and a Mother Information Form at 2 weeks postpartum.

         Results indicated that no significant differences were found between the two groups on the summated sensory and affective pain scores (F (1, 158) = 3.32, p = .07) and the Present Pain Index (z = -.778, p = .436). However, significant differences were found between groups on present pain intensity as measured by the VAS (F (1, 158) = 6.736, p = .010).  

         Implications for nursing practice include the need for nurses who are teaching prepared childbirth classes and working in prenatal clinics/offices to discuss the reasons for perineal trauma with their prenatal patients and the interventions that these women can use to assist them with perineal pain after birth.