Advances in protecting the perineum and reducing episiotomy in a maternity-school

Historical series from 2010 to 2022

Bibliographic Data

ID23310792
AuthorsLuana Beatriz Lemes (0000-0003-4616-6746, Universidade de São Paulo), Jamile Claro De Castro Bussadori (0000-0002-3048-5593, Universidade Federal de São Carlos), Bruna Dias Alonso (0000-0001-8259-4807, Centro Universitário das Faculdades Metropolitanas Unidas), Denise Yoshie Niy (0000-0003-0140-2063, Universidade Brasil), Heloisa De Oliveira Salgado (0000-0001-8530-8925, Instituto Adolfo Lutz), Caio Antonio de Campos Prado (0000-0003-1767-4725, Universidade de São Paulo), Elaine Christine Dantas Moisés (0000-0001-9099-4544, Universidade de São Paulo), Carmen Simone Grilo Diniz (0000-0002-0069-2532, Universidade de São Paulo)
Year2026
Volume31
Issue6
Publication date2026-01-01
Open AccessYes
TypeARTICLE
VenueCiência & Saúde Coletiva (JOURNAL)
Journal identifiersISSN: 1413-8123 • E-ISSN: 1678-4561
PublisherFapUNIFESP (SciELO) (PUBLISHER)
DOI10.1590/1413-81232026316.15072023en
OpenAlexW7171417433
LanguageEN
References cited16

Introduction: a positive and safe childbirth experience remains a challenge for parturients worldwide, including in Brazil. Objective: to describe and analyze changes in perineal care and episiotomy rates at a maternity teaching hospital in São Paulo, Brazil, and to identify the strategies that facilitate the implementation of evidencebased practices. Methods: a mixed-methods study analyzed changes in the model of care and episiotomy rates using medical record data (2010 to 2022), applying elements of the Change Laboratory methodology and the historical and cultural analysis of the activity system. Results: the episiotomy rate was 70% among primiparous women and 35% in the general population in 2010, decreasing to 0.7% and 0.5%, respectively, in 2022, with 75% of parturients (65% of primiparous women) having perineal integrity or first-degree perineal lacerations. Contributors to change: development of protocols, indicator record, mandatory recording of episiotomies, team training, reduced use of forceps, and strengthened communication strategies with parturients. Conclusion: episiotomy rates can be reduced even in teaching hospitals when training is according to evidence-based practices and human rights.

Childbirth · Episiotomy · Maternity care · Medical record · Perineum · Population · Pregnancy · Male Reproductive Health Studies · Maternal and Perinatal Health Interventions · Pelvic floor disorders treatments

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