Perineal follow-up is usually planned on the degree of the tear and nothing else. The variable that carries at least as much signal is how long the active second stage ran, and it is already written in the partogram.
When you see a woman for her postnatal check, look at the second stage duration before you look at the repair note. A long second stage with a deep second-degree tear is the combination that should get a scheduled review rather than safety-netting advice — and it costs nothing to identify, because the number is already recorded.
The same reading works the other way. A short second stage with a clean repair and no symptoms at the first check is a woman who genuinely does not need to be brought back.
- Read the second stage duration before the repair note at the postnatal check
- Long second stage plus deep tear equals a scheduled review, not advice to come back if worried
- A clean repair after a short second stage is a safe discharge
- Ask about pain on sitting and offensive discharge specifically — women under-report both
Why it matters
The information that would triage postnatal perineal follow-up is already in the notes and is routinely ignored.
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