Abstract
Review of historical literature confirms that perineal injury has occurred during childbirth throughout the ages and that various methods and material were used by accoucheurs in an attempt to restore the integrity of severely traumatised tissue. Perineal stitching following childbirth was advocated in ancient writings on midwifery and obstetrics, however the procedure was not routinely practiced.
Women remained the prominent figure during confinements in the early centuries and male physicians or barber-surgeons were only called in as a last resort if problems occurred. During the eighteenth century the introduction of forceps together with episiotomy to facilitate difficult deliveries had a major impact on the extent of perineal trauma and its subsequent repair. Furthermore, women were encouraged to deliver in a more supine position rather than upright so the perineum was more accessible and the full extent of perineal trauma sustained could be assessed. During this period more attention was made to minimising perineal trauma and various methods including supporting the perineum and applying pressure to the vertex to prevent rapid expulsion were implemented. By the end of the nineteenth century practitioners were advised to suture all perineal trauma. However, it was not until the early twentieth century that local anaesthetic was advocated to ease the pain prior to performing and suturing episiotomies. In the UK, midwives did not receive any formal training until the late eighteenth century and it was not until the late twentieth century that midwives were permitted to undertake perineal suturing.
“May the lessons of the past be a guide to the future”
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References
Audit Commission. First class delivery: improving maternity services in England and Wales. London: Audit Commission Publications; 1997.
Beatty TE. Contributions to medicine and midwifery. Dublin: Fannin and Co.; 1866. p. 567.
Bender S. Obstetrics for pupil midwives. London: William Heinemann Medical Books Limited; 1968. p. 159.
Black JW. Selected obstetrical & gynaecological works of Sir James Y. Simpson, Bart. Edinburgh: Adam and Charles Black; 1871. p. 65.
Catalogue and report of obstetrical and other instruments. London: Longmans, Green and Co.; 1867. p. 172.
Christhilf SM, Monias MB. Knotless episiorrhaphy as a positive approach towards eliminating postpartum perineal distress. Am J Obstet Gynecol. 1962;84(6):812–8.
DeLee JB. Obstetrics for nurses. Philadelphia: W.B.Saunders; 1904.
DeLee JB. The prophylactic forceps operation. Am J Obstet Gynecol. 1920;1:34.
Derry DE. Note on five pelves of women of the Eleventh Dynasty in Egypt. J Obstet Gynaecol Br Emp. 1935;xiii:490–5.
Detlefsen GU, Vinther S, Larsen P, Schroeder E. Intradermal suturing of episiotomy wounds compared with interrupted sutures (transl). Ugeskr Laeger. 1980;142:3117–20.
Donald I. Practical obstetric problems. London: Lloyd-Luke; 1979.
Eccles A. Obstetrics and gynaecology in Tudor and Stuart England. 1st ed. London: Croom Helm Ltd; 1982.
Fleming N. Comparison of women with different perineal conditions after childbirth. Ann Arbor: UMI; 1987.
Fleming N. Can the suturing method make a difference in postpartum perineal pain? J Nurse-Midwifery. 1990;35(1):19–25.
Floud E. Protecting the perineum in childbirth 1: a retrospective view. Br J Midwifery. 1994;2(6):258–63.
Flood C. The real reason for performing episiotomies. World Med. 1982;17:51.
Gelis J. History of childbirth. 2nd ed. Cambridge: Polity Press; 1991.
Graham H. Eternal eve. Britain: William Heinemann Medical Books LTD; 1950.
Greenshields W, ulme H H. The perineum in childbirth: a survey of women’s experiences and midwifery practices. London: National Childbirth Trust; 1993.
Guilhem P, Pontonnier A, Espagno G. Episiotomie prophylactique. Suture intradermique. Gynecol Obstet. 1960;59(2):261–7.
Guillemeau J. Child-birth or the happy deliverie of women. London: Printed by A Hatfield; 1612.
Harvie J. Practicle directions, shewing ‘A Method of pefering the PERINǼUM IN BIRTH’. Printed for D. Wilson and G Nicol, London; 1767.
Herman GE. Difficult labour. A guide to its management for students and practitioners. London: Cassell and Company, Limited; 1898.
Isager-Sally L, Legarth J, Jacobsen B, Bostofte E. Episiotomy repair – immediate and long-term sequelae. A prospective randomized study of three different methods of repair. Br J Obstet Gynaecol. 1986;93:420–5.
Jellett H. A short practice of midwifery, embodying the treatment adopted in the Rotunda Hospital, Dublin. London: J & A Churchill; 1897. p. 282–36.
Kettle C, Hills RK, Jones P, Darby L, Gray R, Johanson R. Continuous versus interrupted perineal repair with standard or rapidly absorbed sutures after spontaneous vaginal birth: a randomised controlled trial. Lancet. 2002;359(9325):2217–23.
Kitzinger S, Walters R. Some women’s experience of episiotomy. London: National Childbirth Trust; 1981.
Llewellyn-Jones JD. Commentary. Repair of episiotomies and perineal tears. Br J Obstet Gynaecol. 1987;94:92–3.
Magdi I. Obstetric injuries of the perineum. J Obstet Gynaecol Br Commonw. 1949;49:687–700.
Mandy TE, Christhilf SM, Mandy AJ, Siegel IA. Evaluation of the Rucker method of episiotomy repair as to perineal pain. Am J Surg. 1951;82:251–5.
Myerscough PR. Munro Kerr’s operative obstetrics. 9th ed. London: Bailliére Tindall; 1977.
O’Dowd MJ, Philipp E. The history of obstetrics and gynecology. New York: The Parthenon Publishing Group; 2000.
Olah KS. Subcuticular perineal repair using a new continuous technique. Br J Midwifery. 1994;2(2):67–71.
Ould F. A treatise of midwifery. Dublin: Nelson and Connor; 1742.
Pomeroy RH. Shall we cut and reconstruct the perineum for every primipara? Am J Obstet Dis Woman Child. 1918;78:211–20.
Radcliffe W. Milestones in midwifery. Bristol: John Wright & Sons Ltd; 1967.
Rhodes P. A short history of clinical midwifery. 1st ed. Cheshire: Books for Midwives Press; 1995.
Rucker MP. Perineorraphy with longitudinal sutures. Virginia Med Mon. 1930;7:238–9.
Taliaferro RM. Rigidity of soft parts: delivery effected by incision in the perineum. Stethoscope Vaginia Med Gaz. 1852;2:383.
Temkin O. Soranus’ gynaecology. Baltimore: The John Hopkins University Press; 1956.
Thacker SB, Banta HD. Benefits and risks of episiotomy: an interpretative review of the English language literature 1860–1980. Obstet Gynecol Surv. 1983;38(6):322–34.
Tew M. Safer childbirth? A critical history of maternity care. London: Chapman and Hall; 1990. p. 116.
Towler J, Bramall J. Midwives in history and society. Kent: Croom Helm Ltd; 1986.
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Kettle, C., Ismail, K. (2016). Perineal Trauma: A Historical and International Perspective. In: Ismail, K. (eds) Perineal Trauma at Childbirth. Springer, Cham. https://doi.org/10.1007/978-3-319-14860-1_1
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