UUPP Study: Updating the understanding of perineal practice at the time of birth across the United Kingdom

Authors: Hundley, V., Sheppard, Z., Stride, S. and Way, S.

Conference: 5th European Midwives Association education conference

Dates: 2-3 December 2016


Severe perineal trauma, namely third- and fourth-degree tears, known as severe obstetric anal sphincter injuries (OASIS), impacts on women’s health at the time of birth is associated with long term health consequences such as anal incontinence (RCOG 2015), which can be devastating for women. Significant increases in OASIS in the UK necessitate a comparison of midwifery and obstetric practice with perineal outcomes. The methods: The UUPP research study seeks to address the gaps in current knowledge by: • Collecting relevant NHS policy documentation and best practice.

  • Mapping the current perineal practice by midwives in the UK at the time of birth, using an anonymous on line survey.
  • Gaining an in depth understanding of midwives beliefs and attitudes with regard to perineal care, through focus groups.
  • The study is funded by Wellbeing of Women and supported by the Royal College of Midwives (RCM). Ethics approval has been applied for at Bournemouth University.

The findings:

This is a six month project, the findings would be available ahead of the Conference.

The application to midwifery practice: The study is timely, complementing the ‘Third- and Fourth-degree Tears Project’ where the Royal College of Obstetricians and Gynaecologists and RCM are introducing a package of care known as perineal protection techniques. The study will provide a representative picture of current midwifery practice to support data collected through the RCOG/RCM project prior to the care bundle being implemented.

Only one previous English survey has looked at midwifery practice (Trochez et al 2011) – our study will build on this existing knowledge by exploring wider practice than “hands on / hands off” the perineum, whilst the in-depth qualitative work will provide a clear picture of current UK midwifery practice.

Source: Manual