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Victorian women having their first vaginal birth are four times as likely to experience a third- or fourth-degree perineal tear compared to those having subsequent vaginal births.

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) aims to reduce third- and fourth-degree perineal tears for all Victorian women.

About the Better births for women collaborative

SCV has partnered with the Institute for Healthcare Improvement (IHI) to deliver this collaborative using their proven model for improvement.

We will soon be inviting Victorian maternity services to join the collaborative, which will run from June 2019 to mid 2020.

Look out for expressions of interest, opening in late June. Limited places are available.

Our focus

We will reduce third- and fourth-degree perineal tear rates by 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 2017

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 2017-18

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

Gemma Cooper
Safer Care Victoria
(03) 9096 9062

Page last updated: 11 Jun 2019

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