Irene Chain Kalinowski

Irene Chain Kalinowski

Auckland university of technology
New Zealand

Title: Asian ethnicity, third degree tears and improving outcomes


Irene Chain Kalinowski (1956) was born in Rotherham, South Yorkshire England, to Polish immigrant parents, grew up and trained as a Midwife in Rotherham, South Yorkshire,England and has practiced midwifery through three continents, Europe, the Middle East, and New Zealand. For thirty four years she has practiced midwifery. A journey that has taken her through countries where women have faith in childbirth and through countries where birth is medicalised and where women are fearful of it. To that of Her first book, "The Heart and Soul of Midwifery" Tells a story of how birth became so complex in our western society and how we need to make changes in the way we provide maternity services. She released her Second Book "My Body My Baby" in March 2013, Inspired by her nieces traumatic childbirth experience and the alarming C Section rate.


Vaginal births are often associated with some form of trauma. Third and fourth degree tears that affect the anal sphincter and mucosa can cause long term problems for the woman. Statistical data shown from Two Auckland Hospitals show that 1:15 Indian-Asian women will sustain Third or Fourth degree tears. The objective of this review is to examine why Statistical data from continuity of care caseload of Indian-Asian women where holistic prenatal practices are in place where 1:60 Asian women sustain Third and Fourth degree tears and holistic care provides better outcomes for these women. There are many different types of techniques and interventions used to slow down the birth such as perineal massage and warm compresses and debates between hands off or hands on the perineum to reduce the rate of episiotomies however the gap in the knowledge of lifestyle, culture and dietary intake of Indian-Asian women is lacking in current literature. This gap is detrimental to the welfare of Asian women and the key to the prevention of perineal trauma in these women as poor nutrition will result in impaired perineal muscle, third degree tears, wound infection and delayed healing despite the many hands on, hands off and positioning techniques used to prevent perineal trauma during childbirth. My talk will address the issues around preventing perineal trauma by the application of holistic advice during the prenatal period; that is to understand nutritional intake required to sustain a healthy perineum; to look into the cultural and dietary lifestyle of Indian-Asian women; to correct the poor nutritional status of the woman; to explore observational skills of the midwife; discuss statistical data of perineal outcomes and examine a continuity of care partnership that empowers the woman to take charge of her health so she can celebrate an uncomplicated birth.