Having two midwives attend a birth reduces the risk of severe perineal trauma


  • Heather Mason
  • Univadis Medical News
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The presence of a second midwife during the active phase of the second stage of labour can reduce the risk of severe perineal trauma (SPT) in women giving birth for the first time, according to an article published in The Lancet.

The clinical trial enrolled nulliparous women and women planning a first vaginal birth after caesarean section, aged 18-47 years, randomly assigned to be assisted by either one (n=1513) or two (n=1546) midwives in the late second stage, with the aim of preventing perineal trauma. Midwives were instructed to implement existing prevention models, and the second midwife was to assist in instructing the primary midwife. The primary outcome was the proportion of women with SPT.

The results show that 61 women in the intervention group (two midwives) had an SPT (3.9%) compared with 86 women (5.7%) in the standard care group, a statistically significant difference.

These findings indicate that the presence of a second midwife reduced the incidence of SPT, which is a major concern to women and health care providers as it has the potential for both short-term and long-term morbidity. The second midwife was able to provide preventive strategies and behaviour change techniques.