Goal
This standard aims to reduce unwarranted clinical variation in rates of third or fourth degree perineal tears. It also aims to ensure that women who experience a third or fourth degree perineal tear receive appropriate care to optimise their physical and psychological recovery.
Scope
This clinical care standard applies to all pregnant women who are planning a vaginal birth, and to women who experience a third or fourth degree perineal tear. It applies to care provided during pregnancy, labour, birth and the postpartum period, as well as post-operative and longer-term follow-up care.
Pathway of care
This standard applies to care provided in the following care settings:
- Private obstetric (specialist) care
- Private midwifery care
- Care provided by general practitioners (GPs) and GP obstetricians
- Public hospital maternity and high-risk maternity care, including continuity of care models
- Remote area maternity care
- Community and home-based care
- Postnatal clinics specialising in the treatment of third and fourth degree perineal tears.
In the document, the term ‘clinician’ refers to all types of healthcare providers who deliver direct clinical care to women including:
- Aboriginal and Torres Strait Islander health workers
- Doctors (including obstetricians, gynaecologists, GPs, GP obstetricians, and colorectal surgeons)
- Midwives
- Nurses (including specialist continence nurses and women’s health nurses)
- Physiotherapists
- Psychologists.
What is not covered
This standard does not cover:
- Surgical procedures for third and fourth degree perineal tears, or any complications that arise from this surgery
- Delayed complications associated with a previous third or fourth degree perineal tear
- Other obstetric injuries or complications.