Midwives' experience of perineal rupture prevention : a Minor Field Study in Indonesia

Sammanfattning: Background The complications of getting affected by perineal ruptures by giving birth can cause anxiety and consequences that affect the daily life of the woman. Over ninety percent of Indonesian midwives had neither acquired any basic skills nor received any further professional development training in this area during the three years following their graduation. The main risk factors for perineal ruptures are instrumentally terminated childbirths, nulliparous and a high birth weight of the baby. The midwife has a major impact on the women's further risk of suffering from a perineal rupture. Perineal protection can play a significant role to reduce perineal ruptures.   Aim The aim of the study was to describe midwives experience of perineal ruptures preventive work in Indonesia.   Method This study is based on a MFS in Indonesia. The method chosen was a  qualitative interview study with unstructured interview questions  In total, fifteen midwives were interviewed. Data was analyzed using qualitative content analysis.   Findings During the analysis three categories were identified; The preventive work to protect the perineum, Midwives experience and knowledge of perineal rupture and Factors that increase vaginal ruptures. Six subcategories were identified; Support perineum by hand, To not proceed too fast, Learning by doing, Factors midwife can affect, Factors women can affect and Other factors that may affect.   Conclusion Indonesian midwife's grip to prevent perineal ruptures are similar to what the authors are educated in Sweden. Knowledge and experience appear to be limited due to the midwive´s small number of vaginal births. Midwives emphasized the importance of education and information in their work with perineal protection. They all claimed that if no perineal protection was used, it was more likely for the woman to get a grade three or four rupture. The midwives in Indonesia didn’t use warm compresses and did only use one birth position, Lithotomy position, the women laying on her back. To further make a progress in the midwives preventive work against perineal ruptures is to educate and empower Indonesian midwives knowledge. This is an important aspect due to the large number of midwives with poor experiences.