title: Women's experiences of perineal pain during the immediate postnatal period: a cross-sectional study in Brazil.
abstract: OBJECTIVE
  To identify the severity and prevalence of perineal pain during the post partum in-patient period and associated obstetric, maternal and newborn baby factors following birth.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A postnatal ward of a hospital in São Paulo, Brazil.
  
  
  METHODS
  303 Postnatal women.
  
  
  METHODS
  Interviews and perineal assessment were conducted to evaluate the perineal outcomes (trauma and pain). Data on maternal characteristics and infant anthropometric variables were collected.
  
  
  RESULTS
  Among all women, 80.5% had perineal trauma (60.7% had episiotomy) and 18.5% reported perineal pain. The mean pain intensity score was 4.8 ± 1.9 on the visual analogue scale. Only maternal age (ORa = 1.08) and performance of episiotomy (ORa = 3.80) remained as independent predictors of perineal pain in the final logistic regression model.
  
  
  CONCLUSIONS
  Perineal pain in the immediate postnatal period was highly associated with older maternal age and use of episiotomy, although the overall reporting of perineal pain was low.
  
  
  CONCLUSIONS
  Perineal pain following vaginal birth is associated with interventions during labour as well as with maternal characteristics. Despite the negative impact on a woman's daily activities, perineal pain following birth is neglected by care givers and usually not reported by women who may consider it to be a normal outcome of giving birth. Care providers need to ensure all interventions during labour and birth are informed by evidence of benefit and that barriers to implementation of evidence are addressed. Further work is needed to obtain the views of women in Brazil on their health and well-being following birth.
authors.affiliation: Albert Einstein Hospital, Av. Albert Einstein, 665 São Paulo, SP 05652-000, Brazil. semd@ibest.com.br
authors.forename: Adriana
authors.initials: A
authors.lastname: Amorim Francisco
authors.forename: Sonia Maria
authors.initials: SM
authors.lastname: Junqueira Vasconcellos de Oliveira
authors.forename: Flora Maria
authors.initials: FM
authors.lastname: Barbosa da Silva
authors.forename: Debra
authors.initials: D
authors.lastname: Bick
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Gonzalez Riesco
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000706:statistics & numerical data*; D004841:Episiotomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D010146:Pain / Q000453:epidemiology*; D010147:Pain Measurement / Q000706:statistics & numerical data; D010502:Perineum / Q000293:injuries; D011644:Puerperal Disorders / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D016387:Women's Health; D055815:Young Adult