{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:17:27Z","timestamp":1775693847913,"version":"3.50.1"},"reference-count":44,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"unspecified","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007602","name":"Programme Grants for Applied Research","doi-asserted-by":"publisher","award":["202869"],"award-info":[{"award-number":["202869"]}],"id":[{"id":"10.13039\/501100007602","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,4,11]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Childbirth-related perineal trauma (CRPT) is the most common complication of childbirth, affecting 80% of women after a vaginal birth. However, there is a lack of evidence regarding the care of women following CRPT. Specifically, there is a lack of understanding regarding appropriate postnatal CRPT management, wound assessment and treatment of complications. To improve maternal outcomes, this qualitative study aims to explore women\u2019s and healthcare professionals\u2019 (HCPs) views and experiences of current CRPT wound management and healing to understand what they would want from an assessment tool and related care pathway being developed by the Chapter programme of research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A qualitative study guided by an interpretive descriptive approach will be undertaken to explore the views and experiences around CRPT. This will be conducted through individual interviews and focus groups with women (n\u223c40 participants) who have experienced CRPT within the last 12 months and individual interviews with HCPs (n\u223c25) who care for women who have experienced CRPT. Supported by specialist interpreters where needed, data collection will be audio recorded and transcribed. Data will initially be analysed using codebook thematic analysis for targeted analysis and then using the Framework Method to facilitate a systematic and flexible exploration of themes within and between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study has received ethical approval from the University of Birmingham Science, Technology, Engineering and Mathematical Ethics Review Committee (ERN_23\u20130666). Supported by a Patient Advisory Group, this study will contribute to the overall outputs and dissemination of the Chapter programme of research, including a core outcome set for trials investigating the care of women experiencing CRPT, the development of a Wound Assessment Tool, professional resources and guidelines for best practice and patient resources. Findings will be disseminated via conference presentations, peer-reviewed publications, the National Institute for Health and Care Research Journals Library, relevant media platforms and plain language summaries, including infographics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>ISRCTN registration number<\/jats:title>\n                    <jats:p>45172.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-088248","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T09:00:33Z","timestamp":1745571633000},"page":"e088248","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Exploring views and experiences of childbirth-related perineal trauma: a qualitative study protocol for developing a wound management tool and care pathway"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4018-3855","authenticated-orcid":false,"given":"Laura","family":"Jones","sequence":"first","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9588-5857","authenticated-orcid":false,"given":"Amy","family":"Delicate","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2725-9472","authenticated-orcid":false,"given":"Susan","family":"Waigwa","sequence":"additional","affiliation":[{"name":"Department of English Language and Linguistics, School of English, Drama and Creative Studies, College of Arts and Law, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Hodgetts Morton","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"},{"name":"Birmingham Women\u2019s Hospital, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R Katie","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"},{"name":"Birmingham Women\u2019s Hospital, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Whitehurst","sequence":"additional","affiliation":[{"name":"NIHR Applied Collaboration West Midlands, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3560-2074","authenticated-orcid":false,"given":"Sarah","family":"Hillman","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"},{"name":"Warwick Medical School, University of Warwick, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"2025121223140736000_15.4.e088248.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g6829","article-title":"Managing perineal trauma after childbirth","volume":"349","author":"Webb","year":"2014","journal-title":"BMJ"},{"key":"2025121223140736000_15.4.e088248.2","unstructured":"NHS Digital . NHS maternity statistics 2018-19. Health and Social Care Information Centre, 2019. Available: https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/nhs-maternity-statistics\/2018-19"},{"key":"2025121223140736000_15.4.e088248.3","unstructured":"NMPA Project Team . National maternity and perinatal audit: clinical report 2019. London: RCOG, 2019. Available: https:\/\/www.hqip.org.uk\/resource\/national-maternity-and-perinatal-audit-nmpa-clinical-report-2019\/"},{"key":"2025121223140736000_15.4.e088248.4","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1007\/s10995-019-02732-5","article-title":"Birth-Related Perineal Trauma in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis","volume":"23","author":"Aguiar","year":"2019","journal-title":"Matern Child Health J"},{"key":"2025121223140736000_15.4.e088248.5","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2393-13-59","article-title":"Incidence of and risk factors for perineal trauma: a prospective observational study","volume":"13","author":"Smith","year":"2013","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025121223140736000_15.4.e088248.6","article-title":"Continuous and interrupted suturing techniques for repair of episiotomy or second-degree tears","volume":"11","author":"Kettle","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121223140736000_15.4.e088248.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0287779","article-title":"Women\u2019s experiences of anal incontinence following vaginal birth: A qualitative study of missed opportunities in routine care contacts","volume":"18","author":"Parsons","year":"2023","journal-title":"PLoS One"},{"key":"2025121223140736000_15.4.e088248.8","unstructured":"Royal College of Obstetricians and Gynaecologists . Management of third and fourth degree tears. Green top guideline no 29. 2020. Available: https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/gtg29\/"},{"key":"2025121223140736000_15.4.e088248.9","unstructured":"Royal College of Obstetricians and Gynaecologists . The OASI care bundle project. 2020. Available: https:\/\/www.rcog.org.uk\/en\/guidelines-researchservices\/audit-quality-improvement\/third--and-fourth-degree-tears-project\/"},{"key":"2025121223140736000_15.4.e088248.10","unstructured":"National Institute for Health and Care Excellence . Postnatal care [Ng194] evidence reviews. 2021. Available: https:\/\/www.nice.org.uk\/guidance\/ng194\/evidence\/evidence-reviews-april-2021-9076791277?tab=evidence"},{"key":"2025121223140736000_15.4.e088248.11","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1111\/jan.13724","article-title":"A systematic mixed studies review of women\u2019s experiences of perineal trauma sustained during childbirth","volume":"74","author":"Crookall","year":"2018","journal-title":"J Adv Nurs"},{"key":"2025121223140736000_15.4.e088248.12","first-page":"39","article-title":"Women\u2019s experiences following obstetric anal sphincter injury","volume":"127","author":"d\u2019Almeida","year":"2020","journal-title":"J Pelvic Obstet Gynaecol Physiother"},{"key":"2025121223140736000_15.4.e088248.13","doi-asserted-by":"crossref","first-page":"35","DOI":"10.7748\/phc.2019.e1541","article-title":"The lived experience of women with faecal incontinence after childbirth: a thematic synthesis","volume":"29","author":"MacLellan","year":"2019","journal-title":"Prim Health Care"},{"key":"2025121223140736000_15.4.e088248.14","doi-asserted-by":"crossref","DOI":"10.1016\/j.midw.2020.102820","article-title":"Women\u2019s experience of obstetric anal sphincter injury following childbirth: An integrated review","volume":"91","author":"Darmody","year":"2020","journal-title":"Midwifery"},{"key":"2025121223140736000_15.4.e088248.15","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.ejogrb.2023.09.010","article-title":"A systematic review and meta-synthesis of qualitative studies on childbirth perineal trauma for the development of a Core Outcome Set","volume":"290","author":"Roman","year":"2023","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025121223140736000_15.4.e088248.16","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1111\/jan.12005","article-title":"Women\u2019s experiences following severe perineal trauma: a meta-ethnographic synthesis","volume":"69","author":"Priddis","year":"2013","journal-title":"J Adv Nurs"},{"key":"2025121223140736000_15.4.e088248.17","unstructured":"National Institute for Health and Care Excellence . Postnatal care NICE guideline. 2021. Available: www.nice.org.uk\/guidance\/ng194"},{"key":"2025121223140736000_15.4.e088248.18","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2393-12-57","article-title":"How good are we at implementing evidence to support the management of birth related perineal trauma? A UK wide survey of midwifery practice","volume":"12","author":"Bick","year":"2012","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025121223140736000_15.4.e088248.19","doi-asserted-by":"crossref","first-page":"7","DOI":"10.12968\/bjom.2013.21.1.7","article-title":"Midwives\u2019 experiences of sphincter tears","volume":"21","author":"Lindberg","year":"2013","journal-title":"Br J Midwifery"},{"key":"2025121223140736000_15.4.e088248.20","doi-asserted-by":"crossref","unstructured":"MacLellan J , Gould J , Lewis-Tulett S . Midwifery assessment of the perineum after childbirth: an exploration of competence and confidence. TPM 2021;24. doi:10.55975\/XANL4314","DOI":"10.55975\/XANL4314"},{"key":"2025121223140736000_15.4.e088248.21","unstructured":"National Health Service (NHS) England . NHS reference costs 2018\/19. 2018. Available: https:\/\/www.england.nhs.uk\/national-cost-collection\/#ncc1819"},{"key":"2025121223140736000_15.4.e088248.22","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.o607","article-title":"Ethnic health inequalities in the NHS","volume":"376","author":"Patel","year":"2022","journal-title":"BMJ"},{"key":"2025121223140736000_15.4.e088248.23","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.puhe.2020.07.027","article-title":"A systematic review of the factors - barriers and enablers - affecting the implementation of clinical commissioning policy to reduce health inequalities in the National Health Service (NHS), UK","volume":"186","author":"Regmi","year":"2020","journal-title":"Public Health (Fairfax)"},{"key":"2025121223140736000_15.4.e088248.24","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2024-086724","article-title":"Childbirth Acquired Perineal Trauma study (CHAPTER): a UK prospective cohort study protocol","volume":"14","author":"Hodgetts Morton","year":"2024","journal-title":"BMJ Open"},{"key":"2025121223140736000_15.4.e088248.25","first-page":"6","article-title":"REEDA: evaluating postpartum healing","volume":"19","author":"Davidson","year":"1974","journal-title":"J Nurse Midwifery"},{"key":"2025121223140736000_15.4.e088248.26","first-page":"43","article-title":"Validity and reliability of the Perineal Assessment Tool","volume":"48","author":"Nix","year":"2002","journal-title":"Ostomy Wound Manage"},{"key":"2025121223140736000_15.4.e088248.27","unstructured":"Oxford Health NHS Trust . Oxford wound healing pathway. 2018. Available: https:\/\/www.oxfordhealth.nhs.uk\/wp-content\/uploads\/2015\/08\/Wound-healing-pathway-and-risk-assessment-tool-V2.pdf"},{"key":"2025121223140736000_15.4.e088248.28","unstructured":"Thorne S . The art (and science) of critiquing. In: Completing a qualitative project: details and dialogue. 1997: 117\u201332."},{"key":"2025121223140736000_15.4.e088248.29","doi-asserted-by":"publisher","DOI":"10.1177\/1049732309344612"},{"key":"2025121223140736000_15.4.e088248.30","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1080\/02646838.2023.2228095","article-title":"Research on stillbirth: back and forth between the researcher\u2019s and mother\u2019s perspective","volume":"41","author":"Deforges","year":"2023","journal-title":"J Reprod Infant Psychol"},{"key":"2025121223140736000_15.4.e088248.31","unstructured":"Parker C , Scott S , Geddes A . Snowball sampling. SAGE Research Methods Foundations, 2019."},{"key":"2025121223140736000_15.4.e088248.32","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1111\/hex.13724","article-title":"\u201cImposter participants\u201d in online qualitative research, a new and increasing threat to data integrity?","volume":"26","author":"Ridge","year":"2023","journal-title":"Health Expect"},{"key":"2025121223140736000_15.4.e088248.33","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"2025121223140736000_15.4.e088248.34","doi-asserted-by":"publisher","DOI":"10.1177\/1473325015585613"},{"key":"2025121223140736000_15.4.e088248.35","doi-asserted-by":"crossref","DOI":"10.1136\/bmjspcare-2015-000892","article-title":"Considerations and recommendations for conducting qualitative research interviews with palliative and end-of-life care patients in the home setting: a consensus paper","volume":"9","author":"Sivell","year":"2019","journal-title":"BMJ Support Palliat Care"},{"key":"2025121223140736000_15.4.e088248.36","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2929.2006.02418.x"},{"key":"2025121223140736000_15.4.e088248.37","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1628806"},{"key":"2025121223140736000_15.4.e088248.38","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research","volume":"13","author":"Gale","year":"2013","journal-title":"BMC Med Res Methodol"},{"key":"2025121223140736000_15.4.e088248.39","unstructured":"Ritchie J , Lewis J , Nicholls CM , et al . Qualitative research practice: a guide for social science students and researchers. Sage, 2013."},{"key":"2025121223140736000_15.4.e088248.40","unstructured":"Patton MQ . Qualitative research & evaluation methods: integrating theory and practice. Sage publications, 2014."},{"key":"2025121223140736000_15.4.e088248.41","unstructured":"Health and Care Research Wales . Public involvemnet in research impact toolkit (PIRIT). 2023. Available: www.healthandcareresearchwales.org\/about\/news\/public-involvement-research-impact-toolkit-pirit"},{"key":"2025121223140736000_15.4.e088248.42","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1002\/nur.21743","article-title":"Sensitive Interviewing in Qualitative Research","volume":"39","author":"Dempsey","year":"2016","journal-title":"Res Nurs Health"},{"key":"2025121223140736000_15.4.e088248.43","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2008.10.008"},{"key":"2025121223140736000_15.4.e088248.44","unstructured":"World Health Organization . Process of translation and adaptation of instruments. 2020. Available: https:\/\/www.who.int\/substance_abuse\/research_tools\/translation\/en"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-088248","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:14:18Z","timestamp":1765610058000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-088248"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":44,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,25]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bmjopen-2024-088248"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-088248","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}