Paper short abstract:

Located as part of a ‘maternity care crisis’, the care for ‘second-degree’ vaginal tears is a matter of concern. We explore how attending to ‘second-degree’ vaginal tears as mundane ‘classification work’ in care practice allows us to intervene in the improvement of maternity and postpartum care.

Paper long abstract:

Located as part of a larger ‘maternity care crisis’, the care for vaginal tears has, in Sweden and beyond, become a public and political matter of concern. In particular, improving the handling of ‘second-degree’ vaginal tears – i.e. a tear in the vagina and/or perineal muscle that needs suturing – has been enacted as key for improving maternity and postpartum care. As a daily, yet mundane and taken-for-granted, practice, the classification of vaginal tears plays an important role here. What care routines are followed – and which are not – is intimately connected to ‘classification work’ (Bowker & Star 1999). In this presentation, we draw upon interviews, and a workshop, with gynaecologists, midwives, physiotherapists, sexologists, and policy-actors managing and/or treating ‘second-degree’ vaginal tears to explore what the classifying of vaginal tears as ‘second-degree’ does.

The mundane act of classifying a tear is far from easy but has significant consequences. Notably, while the distinction between a ‘second-degree’ and a ‘third-degree’ tear may not be given in practice, the consequences are pivotal. Whereas ‘third-degree’ patients are closely followed up, follow-up care for ‘second-degree’ tears is largely absent. Consequently, we analyse the complexities and consequences of classification work concerning ‘second-degree’ tears, such as in relation to suturing and follow-up postpartum care. Ultimately, we ask how attending to the grading and classifying of vaginal tears as ‘second-degree’ as a mundane ‘daily life matter’ (Mol et al. 2010) allows us to intervene in debates about how to improve the care for vaginal tears.