Page 107 - Petelin, Ana, ur. 2024. Zdravje delovno aktivnih in starejših odraslih / Health of Working-Age and Older Adults. Zbornik povzetkov z recenzijo ▪︎ Book of Abstracts. Koper: Založba Univerze na Primorskem/University of Primorska Press

The Importance of Rehabilitation for the Quality of Life of Women
After a Third-Degree Perineal Tear During Childbirth: A Qualitative
Descriptive Study
2
1
Mojca Rostohar , Dorjana Zerbo Šporin , Darija Šćepanović , Mirko Prosen 2
1,2
1 University Medical Center Ljubljana, The Division of Gynaecology and Obstetrics,
Ljubljana, Slovenia
2 University of Primorska Faculty of Health Sciences, Izola, Slovenia
Introduction: One of the most common injuries during vaginal childbirth is perineal
trauma. Severe perineal injuries are classified as third- and fourth-degree tears. In de-
veloped countries, the incidence of these injuries ranges from 0.5% to 5%, while Slove-
nian studies report an incidence of 0.1% to 0.8%. The most common consequences of
third- and fourth-degree perineal tears include issues with incontinence (fecal inconti-
nence, flatulence incontinence, urinary incontinence), pain in the wound or scar area,
and perineal pain. Additionally, there is often pain in the pelvic floor region during dai-
ly activities and/or sexual intercourse, which can significantly affect women‘s quality of
life immediately postpartum and later. The aim of our study was to investigate the ex-
perience of rehabilitation or physiotherapy treatment and its impact on the quality of
life after a third-degree perineal tear.
Methods: A qualitative descriptive method was used. Data were collected through
semi-structured individual interviews. A purposive sample included 11 women who
sustained a third-degree perineal tear during vaginal childbirth, as noted in the hos-
pital discharge summary or confirmed by endoanal ultrasound. Data were analyzed
using content analysis.
Results: Based on reports of their physiotherapy experiences, we found that women
often did not know what to expect from their first physiotherapy session. Some ex- preventiva in rehabilitacija ... | prevention and rehabilitation ...
pressed feelings of fear and tension, mainly due to concerns about potential pain du-
ring the examination of the scar area. Most participants described receiving extensive
information during their first session and felt truly heard for the first time. However,
many women were hesitant to disclose all their symptoms, particularly issues with fe-
cal incontinence, flatulence, and pain during sexual intercourse, with some only discus-
sing these issues in later sessions. Four patients were positively surprised by the ho-
listic approach, while three were bothered by the lack of consistent presence of the
same therapist across different sessions, mainly due to varying approaches. Despi-
te this, they appreciated the maintenance of intimacy during therapies. All partici-
pants reported noticeable improvement in symptoms after completing physiotherapy,
which had a positive impact on their quality of life. This included a return to daily physi-
cal activities such as running, jumping, and swimming, as well as improved relationships
with their partners, especially in terms of sexual health. They emphasized that aware-
ness of such injuries and rehabilitation options should be greater.
Discussion: The role of the physiotherapist in the comprehensive treatment of women
after childbirth with a third-degree perineal tear is very important. Physiotherapy not
only restores functionality but also improves the quality of life of patients. We also
highlight the importance of further research and collaboration among professionals to
continuously improve approaches to this significant health issue.
Keywords: childbirth, perineal tears, quality of life, women‘s health

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