Evidence map›Paper›PMID 39663780›Full record

ArticleBJOG : an international journal of obstetrics and gynaecology2025

A Care Bundle Aiming to Reduce the Risk of Obstetric Anal Sphincter Injury: A Survey of Women's Experiences.

Magdalena Jurczuk, Lizzie Phillips, Posy Bidwell, Dorian Martinez, Louise Silverton, Nick Sevdalis, Jan van der Meulen, Ipek Gurol-Urganci, Ranee Thakar

Abstract readMulticenter Study
In one paragraph

Article in BJOG : an international journal of obstetrics and gynaecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Magdalena JurczukCentre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, London, UK.
Lizzie PhillipsMaternity Services, University Hospital Plymouth NHS Trust, Plymouth, Devon, UK.
Posy BidwellSouth Warwickshire Foundation Trust, Warwick, UK.
Dorian MartinezCentre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, London, UK.
Louise SilvertonRoyal College of Midwives, London, UK.
Nick SevdalisCentre for Behavioural and Implementation Science Interventions, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Jan van der MeulenDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.ORCID https://orcid.org/0000-0002-9451-2335
Ipek Gurol-UrganciCentre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, London, UK.ORCID https://orcid.org/0000-0002-6517-3485
Ranee ThakarObstetrics and Gynaecology, Croydon University Hospitals NHS Trust, Croydon, UK.

Funding

Health Foundation
6 · The paper itself

Abstract

objectiveTo study experiences of women who gave birth in maternity units that have implemented a 'care bundle' quality improvement initiative to reduce obstetric anal sphincter injury (OASI) and associated morbidity.

designPostnatal electronic questionnaire.

settingTwenty-nine maternity units across England, Scotland and Wales. POPULATION: Women with live vaginal births.

methodsDescriptive statistics for quantitative results. Analysis of free-text responses informed by framework method.

main outcome measuresExperience with components of the care bundle: information provision, manual perineal protection (MPP) and post-birth rectal examination.

resultsIn this study, 1208 women completed the survey: 684 (56.6%) said they received antenatal information about perineal health, 377 (31.2%) recalled MPP, and 664 (55.0%) recalled rectal examination. Of the 684 women who said they received antenatal information, 595 (87.0%) agreed that the information was easy to understand, and 423 (61.8%) agreed that it helped them to make their own choices to reduce their OASI risk. One hundred and fifty-four (22.5%) agreed that the information made them fearful about giving birth vaginally. Of the 377 women who recalled MPP, 203 (53.9%) felt it provided them with support, and another 97 (25.7%) did not mind the sensation. Of the 664 women who recalled rectal examination, 281 (42.3%) did not mind the exam, and another 335 (50.5%) felt it was uncomfortable but understood its importance. Free-text responses aligned with quantitative results.

conclusionsMany women did not recall MPP or rectal examination. The reported experiences for those who recalled these components do not support concerns that the OASI care bundle has negative effects on women's experiences.

Indexed as

Anal CanalDelivery, ObstetricLacerationsObstetric Labor ComplicationsPatient Care BundlesPerineumAdultEnglandFemaleHumansPregnancyQuality ImprovementSurveys and QuestionnairesWaleschildbirth experiencedecision‐makingintrapartum careobstetric anal sphincter injuryperineal tearwomen's views

Identifiers

PMID39663780
PMCPMC11879911

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.