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Women having their first birth vaginally in Victoria are four times more likely to experience a severe perineal laceration (third- or fourth-degree tear) compared to those having a subsequent birth vaginally (Victorian perinatal services performance indicators 2018–19 report).

This can have devastating long-term or lifelong impacts on physical and psychological wellbeing. Many of these tears are avoidable.

Through the Better births for women collaborative, Safer Care Victoria (SCV) will improve birth outcomes for all women giving birth in Victoria.

About the Better births for women collaborative

Using our partnership with the Institute for Healthcare Improvement (IHI), we will test and spread the success of evidence-based clinical care bundles to reduce third- and fourth- degree perineal tear rates, focusing on five clinically endorsed interventions.

Through the collaborative, we will partner with clinicians to better detect and manage risk factors to prevent perineal trauma and improve the care and experience of women through shared decision making.

Participating maternity services

Ballarat Health Services Northern Health
Barwon Health St John of God Bendigo Hospital
Bass Coast Regional Health St Vincent's Private Hospital
Central Gippsland Health Service (Sale) South West Healthcare Group (Warrnambool)
Djerriwarrh Health Services Western District Health Service (Hamilton)
East Grampians Health Service (Ararat) Western Health
Kilmore and District Hospital Wimmera Health Care Group (Horsham)

Our focus

We're focusing on five key aspects of care:

  • application of warm perineal compress during labour 
  • hands on to support the perineum, with gentle verbal guidance   
  • episiotomy performed when indicated (during instrumental delivery and at 60 degrees) 
  • genito-anal examination on all women post birth  
  • grading of perineal tear and review by experienced clinician.  


A reduction in the rate of third- and fourth-degree perineal tears across Victorian maternity services by July 2020.

Resources for health services

Partnering in healthcare framework

Our Partnering in healthcare framework and self-assessment tool will help services involve women and their families, respond to their needs and expectations and deliver care that is safe, woman-centred, equitable and effective.

Victoria’s Mothers, Babies and Children report 2018

The Victoria’s Mothers, Babies and Children report from the Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM), provides access to comprehensive data on all maternal, perinatal and paediatric mortality and morbidity, including stillbirth.

Perinatal services performance indicators 2018-19

The Victorian Perinatal services performance indicators report provides benchmarking data on a range of clinical indicators, including smoking cessation and detection of fetal growth restriction.

Get in touch

Felicity Czarnecki
Safer Care Victoria
(03) 9096 1308

Page last updated: 17 Dec 2019

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