The Chapter Study – Childbirth Acquired Perineal Trauma Study

A study to optimise the care of women following childbirth related perineal trauma (CRPT).

The Chapter research team brings together women, the public, midwives, doctors and academics to improve the care for women with CRPT.

Each year in the UK, 80% of women who give birth vaginally (450,000 women), experience damage to the surrounding area. This may result from tears or cuts to tissues, muscles and skin around the bladder, vagina and perineum (the skin between the vagina and back passage). This is called Childbirth Related Perineal Trauma (CRPT). CRPT needs to be dealt with quickly and effectively. If not treated, women can be left with pelvic floor problems (e.g. incontinence) or psychological problems (e.g. bonding with baby).

The Chapter Study programme involves four interlinked work packages, with patient and public involvement (PPI) throughout, with the aim of standardising and optimising the care of women with CRPT. The work packages involve -

  • Summarising existing research and good practice worldwide
  • Carrying out research using existing information to understand how frequent and serious any complications are
  • Develop and testing a tool to assess CRPT and help direct care more effectively
  • Working with mothers and healthcare professionals to understand their views on what is important to them, how an assessment tool might be used and how any treatment should be delivered.

We are looking for people with lived experience of childbirth acquired perineal trauma in the last 5 years to join the Chapter Patient Advisory Group or focus groups.

If you would like to find out more please email the Chapter Study team at

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Katie MorrisProfessor Katie Morris

Research Group Lead

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Project description


Primary aim: to work with women and stakeholders to optimise the care of women following CRPT in the NHS

Secondary aims: to summarise the published evidence in this area for global settings and to work with collaborators representing global stakeholders to consider the relevance of outputs for global settings, and to develop a network for dissemination and future research.


1. To describe the current prevalence, management and outcomes of CRPT.

2. To determine risk factors for developing complications of CRPT, risk factors or predictors of health problems following complications of CRPT.

3. To summarise the evidence from a prospective cohort study, data linkage study, published literature, women’s and Healthcare Professionals (HCPs) views related to prediction, assessment, diagnosis and management of CRPT and complications of CRPT.

4. To explore with key stakeholders (women, clinicians and primary and secondary health care services) their views on CRPT wound management and healing, what they would want from an assessment tool and outcomes that are important to them.

5. To develop and test a reliable, valid wound assessment tool and care pathway for assessment and treatment guidance of CRPT wounds.

6. To determine the important outcomes following CRPT for women, clinicians and the NHS and design a tool to capture these outcomes (CRPT management, outcomes and women’s experience) and co-develop a core outcome set for CRPT.

7. To integrate, synthesize, disseminate the programme outputs, to optimise outcomes for women and the NHS.  To develop future directions for research and clinical practice.

Research Plan and Methods

The Chapter Study will include a mixed-methods programme of four interlinked work packages with PPI throughout culminating in an integrated synthesis.  The work packages are:

  • Work Package 1 – Awareness of CRPT

    • Prospective observational cohort study
    • Data linkage between Primary and Secondary Care to determine long-term outcomes in a nationally representative sample
  • Work Package 2 – Data Synthesis

    • Systematic reviews of relevant literature to inform prediction, assessment, diagnosis, management and outcomes of CRPT and complications
    • Qualitative research with women and HCPs
  • Work Package 3 – Resource Development

    • CRPT wound assessment tool development
    • Development and testing of PROM
    • Development of care pathways (including utilisation of tools)
    • Core Outcome set for CRPT
  • Work Package 4 – Synthesis, dissemination, impact and future development

    • Synthesis
    • Dissemination
    • Impact
    • Future development

Current projects

  • Prospective observational cohort study
  • Data linkage between Primary and Secondary Care to determine long-term outcomes in a nationally representative sample

Opportunity to be involved in research

Have you had a baby in the last 12 months?​

Did you experience a cut and/or tear during vaginal childbirth?​

If yes, we would like to hear about your experiences and your views 

about the care you received 

At the moment, we don’t have a standardised care process (tool) to help doctors, midwives and nurses to manage cuts and tears after childbirth if there are problems. It’s really important that we develop a tool to make sure that women affected by cuts and tears during childbirth are getting the best care. The information that we collect as part of this study, will be used to inform the development of a tool and guidance, and will hopefully improve care for women in the future.   

There are two options for taking part. You can choose to take part in either a one-to-one discussion (interview) or in a group discussion with other women affected by tears and cuts during childbirth (discussion group). Discussions will be led by members of the Chapter research team who are experienced in talking about women’s experiences of childbirth. You can participate on a date and time to suit you and at a location of your choice. For example, online, in your home, at the University, at a community group or other public location. 

People who take part in an interview will be offered a £25 shopping voucher and those who take part in a discussion group will be offered a £40 shopping voucher each as a thank you for your time. The discussion groups take longer and so this is why those participants receive more.  If you take part in a face-to-face interview or discussion group, then we will cover any reasonable travel expenses based on standardised public transport/milage calculations.  

To find out more or to express your interest in taking part please call Laura on 0121 414 3024 or email

Do you have experience caring for women who have experienced childbirth related perineal trauma (CRPT)? 

The Chapter study team would like to talk to you about your experiences of caring for women with CRPT, care pathways and the development of a wound assessment tool. Discussions take about an hour and can be done via video conferencing or phone at a time convenient to you. You will be offered a £25 shopping voucher for your time.

To find out more or to express your interest in taking part please call Laura on +44(0)121 414 3024 or e-mail

We are looking for people with lived experience of childbirth acquired perineal trauma in the

last 5 years to join the Chapter Patient Advisory Group or focus groups.

Do you have lived experience of childbirth related perineal trauma (CRPT) from within the last 5 years? You may have experienced this yourself or be the partner of someone who has suffered CRPT.  If so the Chapter Study at the University of Birmingham is looking for members of the public to support research by being part of the Patient Advisory Group (starting Spring 2022) or by taking part in focus groups and sharing your views and experience.  Over 80% of women who give birth vaginally suffer some form of CRPT, that’s over 450,000 women a year. If not treated correctly women can be left with physical and psychological problems.  The Chapter Study wants to find out how to improve the care of patients experiencing CRPT.  To find out more about how you can use your voice to help shape and inform this research please -





This study is funded by the National Institute for Health and Care Research (NIHR) [Programme Grants for Applied Research (202869)].  The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

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