Medical staff’s influence on patient outcomes has become a subject of interest. We evaluated experienced midwives and compared their performance concerning perineal lacerations (PL).
In a retrospective cohort study, 1937 women with singleton pregnancies who had delivered spontaneously with a cephalic presentation by experienced midwives in the Medical University of Vienna from January 2009 to April 2014 were included. As predictive parameters, we included basic patient-, pregnancy- and delivery-related characteristics including the individual midwife who delivered the child. The incidence of PL was the main outcome measure.
Overall PL and severe PL were found in 508/1937 (26.2 %) and 19/1937 women (1.0 %), respectively. In a multivariate analysis for PL of any degree, maternal age (ß = 0.170 ± 0.080), gestational age at delivery (ß = 0.190 ± 0.320), and birth weight (ß = 0.002 ± 0.000) significantly increased the risk, whereas multiparity (ß = −0.379 ± 0.141) and mediolateral episiotomy (ß = −1.514 ± 0.284) decreased it ( p < 0.05). In addition, the individual midwife who delivered the child was a significant influencing factor, with ß-values ranging from −0.028 to 0.899 compared to the reference midwife. For severe PL, the midwife was not of significant influence.