{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T08:29:09Z","timestamp":1758270549535},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,8,7]],"date-time":"2015-08-07T00:00:00Z","timestamp":1438905600000},"content-version":"vor","delay-in-days":37,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Perineal lacerations during birth can cause ongoing physical, psychological, and social problems. However, the prevalence of lacerations following normal spontaneous vaginal birth in women with low\u2010risk pregnancies is unknown. We investigated the prevalence of perineal lacerations and factors associated with lacerations among low\u2010risk Japanese women who had normal spontaneous vaginal births.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pregnant women who were cared for between January 1, 2008, and June 30, 2011, in 3 midwife\u2010led birth centers in Tokyo, Japan, where invasive medical interventions are rarely applied, were included. We investigated the prevalence of perineal lacerations and conducted univariate and multivariate analyses on the relationship between the prevalence of lacerations and selected maternal and neonatal characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1881 pregnant women had initial antenatal care at one of the 3 study sites. Of these, 1521 were eligible for inclusion. Intact perineum rates were 49.5% (209\/422) and 69.9% (768\/1099) in nulliparous and multiparous women, respectively. First\u2010degree lacerations occurred in 36.7% (155\/422) of nulliparous women and 27.1% (298\/1099) of multiparous women, and second\u2010degree lacerations occurred in 13.5% (57\/422) of nulliparous women and 3.0% (33\/1099) of multiparous women. One multiparous woman experienced a third\u2010degree laceration (0.1%). No women suffered fourth\u2010degree or cervical lacerations. Logistic regression analyses showed that older age (\u2265 35 years), the hands\u2010and\u2010knees position, and using a birthing chair during birth increased the risk of perineal laceration both in nulliparous and in multiparous women. In addition, waterbirths increased the risk of perineal laceration in multiparous women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In normal spontaneous vaginal births among a low\u2010risk population, it is possible to avoid episiotomy and achieve a high rate of intact perineum, with few second\u2010degree and third\u2010degree lacerations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jmwh.12324","type":"journal-article","created":{"date-parts":[[2015,8,7]],"date-time":"2015-08-07T22:00:03Z","timestamp":1438984803000},"page":"419-427","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Prevalence of Perineal Lacerations in Women Giving Birth at Midwife\u2010Led Birth Centers in Japan: A Retrospective Descriptive Study"],"prefix":"10.1111","volume":"60","author":[{"given":"Maiko","family":"Suto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Takehara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chizuru","family":"Misago","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuaki","family":"Matsui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,7]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"1401","article-title":"Perineal care","volume":"9","author":"Kettle C","year":"2008","journal-title":"BMJ Clin Evid"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0730-7659.2005.00356.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2006.01593.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1995.tb09132.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1526-9523(01)00205-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-59"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2008.09.001"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.17.2141"},{"issue":"1","key":"e_1_2_8_10_1","first-page":"CD000081","article-title":"Episiotomy for vaginal birth","author":"Carroli G","year":"2009","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12005"},{"issue":"12","key":"e_1_2_8_12_1","first-page":"CD006672","article-title":"Perineal techniques during the second stage of labour for reducing perineal trauma","author":"Aasheim V","year":"2011","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-006-0168-5"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03210.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03040917"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536X.1998.00226.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja13.11003"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.081869"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2009.00322.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-012-2553-6"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2012.12.020"},{"key":"e_1_2_8_22_1","unstructured":"Japanese Midwives Association.Guidelines for independent midwife at birth center. 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