KVINNORS UPPLEVELSER AV PERINEALA BRISTNINGARS PÅVERKAN PÅ VÄLBEFINNANDET EFTER VAGINAL FÖRLOSSNING En systematisk litteraturöversikt

Abstract

Background: Perineal tears are common during vaginal birth and may lead to physical, psychological and social consequences that affect women’s well-being. Previous research indicates that women experience insufficient information, support and follow-up postpartum. A salutogenic perspective and Antonovsky’s theory of Sense of Coherence can help explain how the consequences of perineal tears are interpreted and managed. Aim: To explore women’s experiences of how perineal tears impact well-being after vaginal birth. Method: A systematic literature review of qualitative original articles was conducted following Bettany-Saltikov & McSherry’s nine-step model. Literature searches were performed in CINAHL and PubMed. Inclusion criteria were women who had undergone vaginal birth, all degrees of perineal tears, ethically approved articles published between 2015–2025, written in Swedish or English. Quality appraisal was carried out using SBU’s checklist for qualitative studies. Data analysis followed Bettany-Saltikov & McSherry’s nine step model for qualitative synthesis. Results: In this review, nineteen articles were included. Analysis generated three main categories: physical well-being, psychological well-being and social and cultural well-being. Women experienced that pain, impaired basic functions, incontinence and constipation limited daily life and recovery. Psychological aspects included anxiety, low mood, altered body image and fear of future births. Lack of information and support was also identified as consequences negatively affecting psychological well-being. Socially, women experienced that family support, stigma surrounding intimate issues, financial strain and difficulties with intimacy and sexual life affected their well-being. Conclusion: Perineal tears after vaginal birth can affect women’s well-being physically, psychologically and socially. Based on Antonovsky’s theory, clear and individualized information and responsive care strengthen women’s ability to recover, while insufficient support may lead to reduced security and increased suffering. The findings emphasize the midwife’s central role in promoting long-term well-being through person-centered and salutogenic care.