Factors Influencing Perineal Injury in Women Giving Birth in Natural Childbirth Hospitals

Abstract

Purpose: This study aimed to identify the factors affecting the degree of perineal injury in women who gave birth at a natural childbirth hospital.Methods: This descriptive correlational study aimed to confirm the effect of delivery at a natural childbirth hospital on perineal injury in women. We analyzed the medical records of 358 women who gave birth naturally to infants in the cephalic position at >37 weeks gestation in 2018 at an obstetric clinic in Seoul. Data were analyzed using Spearman rank correlation coefficient to identify variables affecting perineal injury, and multiple regression was used to identify the factors affecting perineal injury. IBM SPSS version 28.0 for windows was used for data analysis.Results: There were significant negative correlations between the degree of perineal injury and birth order (r=0.73, p<0.001), number of previous vaginal deliveries (r=-0.70, p<0.001), and age (r=-0.30, p<0.001). However, there were significant positive correlations between the degree of perineal injury and parity (r=0.83, p<0.001), labor duration in stage I (r=0.35, p<0.001), labor duration in stage II (r=0.37, p<0.001), fluid hydration (r=0.28, p<0.001), epidural anesthesia (r=0.27, p<0.001), and oxygen supply (r=0.26, p<0.001). Factors affecting the degree of perineal injury were parity (b=0.10, p=0.007) and birth order (b=-0.09, p=0.014), and the explanatory power of this model was 52.0% (F=130.054, p<0.001).Conclusion: The degree of perineal injury was highest in the primiparous group and decreased as the birth order increased. Therefore, to prevent perineal injury during childbirth, nursing care with minimal intervention such as epidural anesthesia is required for primiparous women.