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RCOG statement: New joint initiative to prevent severe tearing during childbirth

News 18 March 2016

A collaborative team from the RCOG, the Royal College of Midwives, Croydon Health Services NHS Trust and Plymouth Hospitals NHS Trust has been selected by the Health Foundation, to be part of its £3.5 million improvement programme, Scaling Up Improvement.

The programme is supporting seven healthcare projects in the UK with the aim to improve healthcare delivery and/or the way people manage their own care.

The initiative from the collaborative team aims to standardise practice relating to prevention of third- and fourth-degree perineal tears with the ultimate aim of reducing these in the UK.

Over the last decade, rates of severe perineal tears during childbirth have increased in England. The long term consequences can be severely debilitating and can also affect a woman’s emotional health and day-to-day quality of life. There is no way to completely avoid severe perineal tears, but there are evidence-based interventions and practice which have been shown to significantly decrease rates of severe tears both in  the UK and international settings

The programme consists of a care bundle, a skills development module, and campaign materials to be used in 16 UK maternity units with an overarching aim to standardise practice and reduce the rates of severe tears throughout the UK.

Ranee Thakar, clinical lead of the project and consultant urogynaecologist at Croydon Health NHS Trust, said:

“We are incredibly grateful for the opportunity to continue working collaboratively to scale up our programme which has seen success in reducing third- and fourth-degree tears locally and abroad.

“The long-term consequences of obstetric anal sphincter injuries, include anal and urinary incontinence, can result in significant emotional and medical burden to women. Through improved training, raising awareness of the long term impact of severe tearing and standardising practice among doctors and midwives, we are confident that we can reduce rates significantly in the UK.”

Louise Silverton, Director for Midwifery for the Royal College of Midwives, said:

“The RCM for some time has been concerned at the high rates of serious perineal trauma that some women are experiencing in childbirth. We are delighted to work in collaboration with the RCOG in ensuring care is consistent across the UK.

“Such trauma is linked to future incontinence and can affect many aspects of a woman’s life not only her physical health. This joint initiative will allow us to develop a greater awareness, while the skills development bundle will allow midwives and other healthcare professionals to help reduce national rates of perineal tears.”

Sarah Henderson, Associate Director from the Health Foundation said:

“We are very excited to be working with this project team who have been selected because of their expertise and ambition to achieve real impact through improving the quality of care. We hope that this programme will result in these interventions being widely adopted across the UK.”


For media enquiries, please contact the RCOG press office on 020 7772 644 or email