title: A discussion of some of the literature relating to history, repair and consequences of perineal trauma.
abstract: OBJECTIVE
  to review the key literature on perineal trauma, discussing the historical background, the materials and techniques used, the possible consequences of repair and assess midwives' current and potential contribution to perineal repair.
  
  
  METHODS
  the literature was identified using conventional search techniques: Midwifery Information Resource Service (MIDIRS) and the Cochrane Pregnancy and Childbirth Database. Keywords used during the search were: episiotomy, perineal trauma and adverse effects. Associated keywords words were sexuality, pain and psychology.
  
  
  CONCLUSIONS
  current practice in the UK is inconsistent with the available evidence, perineal trauma can cause long term problems, and midwives are in an ideal position to take forward evidence-based perineal repair.
  
  
  CONCLUSIONS
  midwives need adequate education and training in perineal repair but are likely to be more effective in performing the repair. Systematic evaluation of the impact of extending midwives' influence in this area is essential.
authors.forename: J
authors.initials: J
authors.lastname: Draper
authors.forename: R
authors.initials: R
authors.lastname: Newell
mesh_terms: D004841:Episiotomy / Q000379:methods / Q000451:nursing* / Q000639:trends; D005260:Female; D006801:Humans; D009721:Nurse Midwives; D007744:Obstetric Labor Complications / Q000451:nursing*; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy