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Comparison 1 Newborn outcomes, Outcome 1 Infection in newborns.
Figuras y tablas -
Analysis 1.1

Comparison 1 Newborn outcomes, Outcome 1 Infection in newborns.

Comparison 1 Newborn outcomes, Outcome 2 Umbilical infection of the newborn.
Figuras y tablas -
Analysis 1.2

Comparison 1 Newborn outcomes, Outcome 2 Umbilical infection of the newborn.

Comparison 1 Newborn outcomes, Outcome 3 Neonatal infection at 4 days.
Figuras y tablas -
Analysis 1.3

Comparison 1 Newborn outcomes, Outcome 3 Neonatal infection at 4 days.

Comparison 1 Newborn outcomes, Outcome 4 Infection in newborns during the first month of life.
Figuras y tablas -
Analysis 1.4

Comparison 1 Newborn outcomes, Outcome 4 Infection in newborns during the first month of life.

Comparison 1 Newborn outcomes, Outcome 5 Dacriocistitis or conjunctivitis (first month).
Figuras y tablas -
Analysis 1.5

Comparison 1 Newborn outcomes, Outcome 5 Dacriocistitis or conjunctivitis (first month).

Comparison 1 Newborn outcomes, Outcome 6 Skin infection (first month).
Figuras y tablas -
Analysis 1.6

Comparison 1 Newborn outcomes, Outcome 6 Skin infection (first month).

Comparison 1 Newborn outcomes, Outcome 7 Upper respiratory tract infection during first month.
Figuras y tablas -
Analysis 1.7

Comparison 1 Newborn outcomes, Outcome 7 Upper respiratory tract infection during first month.

Comparison 1 Newborn outcomes, Outcome 8 Lower respiratory tract infection during first month.
Figuras y tablas -
Analysis 1.8

Comparison 1 Newborn outcomes, Outcome 8 Lower respiratory tract infection during first month.

Comparison 1 Newborn outcomes, Outcome 9 Newborn required systemic antibiotics after hospital discharge during the first month.
Figuras y tablas -
Analysis 1.9

Comparison 1 Newborn outcomes, Outcome 9 Newborn required systemic antibiotics after hospital discharge during the first month.

Comparison 1 Newborn outcomes, Outcome 10 Intestinal infection.
Figuras y tablas -
Analysis 1.10

Comparison 1 Newborn outcomes, Outcome 10 Intestinal infection.

Comparison 1 Newborn outcomes, Outcome 11 Meningitis.
Figuras y tablas -
Analysis 1.11

Comparison 1 Newborn outcomes, Outcome 11 Meningitis.

Comparison 1 Newborn outcomes, Outcome 12 Sepsis.
Figuras y tablas -
Analysis 1.12

Comparison 1 Newborn outcomes, Outcome 12 Sepsis.

Comparison 1 Newborn outcomes, Outcome 13 First minute Apgar < 7.
Figuras y tablas -
Analysis 1.13

Comparison 1 Newborn outcomes, Outcome 13 First minute Apgar < 7.

Comparison 1 Newborn outcomes, Outcome 14 Five minute Apgar < 7.
Figuras y tablas -
Analysis 1.14

Comparison 1 Newborn outcomes, Outcome 14 Five minute Apgar < 7.

Comparison 2 Puerperal outcomes, Outcome 1 Perineal tear: skin or superficial tissue without compromising muscle.
Figuras y tablas -
Analysis 2.1

Comparison 2 Puerperal outcomes, Outcome 1 Perineal tear: skin or superficial tissue without compromising muscle.

Comparison 2 Puerperal outcomes, Outcome 2 Perineal tear: perineal muscle without anal muscles.
Figuras y tablas -
Analysis 2.2

Comparison 2 Puerperal outcomes, Outcome 2 Perineal tear: perineal muscle without anal muscles.

Comparison 2 Puerperal outcomes, Outcome 3 Perineal tear: compromises anal muscles but not the mucosa.
Figuras y tablas -
Analysis 2.3

Comparison 2 Puerperal outcomes, Outcome 3 Perineal tear: compromises anal muscles but not the mucosa.

Comparison 2 Puerperal outcomes, Outcome 4 Perineal tear: complete tear that compromises anal mucosa.
Figuras y tablas -
Analysis 2.4

Comparison 2 Puerperal outcomes, Outcome 4 Perineal tear: complete tear that compromises anal mucosa.

Comparison 2 Puerperal outcomes, Outcome 5 Infections during puerperium.
Figuras y tablas -
Analysis 2.5

Comparison 2 Puerperal outcomes, Outcome 5 Infections during puerperium.

Comparison 2 Puerperal outcomes, Outcome 6 Episiotomy dehiscence.
Figuras y tablas -
Analysis 2.6

Comparison 2 Puerperal outcomes, Outcome 6 Episiotomy dehiscence.

Comparison 2 Puerperal outcomes, Outcome 7 Urinary tract infection.
Figuras y tablas -
Analysis 2.7

Comparison 2 Puerperal outcomes, Outcome 7 Urinary tract infection.

Comparison 2 Puerperal outcomes, Outcome 8 Pelvic infection: infected episiotomy.
Figuras y tablas -
Analysis 2.8

Comparison 2 Puerperal outcomes, Outcome 8 Pelvic infection: infected episiotomy.

Comparison 2 Puerperal outcomes, Outcome 9 Pelvic infection: vulvovaginitis.
Figuras y tablas -
Analysis 2.9

Comparison 2 Puerperal outcomes, Outcome 9 Pelvic infection: vulvovaginitis.

Comparison 2 Puerperal outcomes, Outcome 10 Pelvic infection: endometritis.
Figuras y tablas -
Analysis 2.10

Comparison 2 Puerperal outcomes, Outcome 10 Pelvic infection: endometritis.

Comparison 2 Puerperal outcomes, Outcome 11 Pelvic infection: myometritis.
Figuras y tablas -
Analysis 2.11

Comparison 2 Puerperal outcomes, Outcome 11 Pelvic infection: myometritis.

Comparison 2 Puerperal outcomes, Outcome 12 Needed postpartum systemic antibiotics.
Figuras y tablas -
Analysis 2.12

Comparison 2 Puerperal outcomes, Outcome 12 Needed postpartum systemic antibiotics.

Comparison 2 Puerperal outcomes, Outcome 13 No episiotomy wound ‐ no further tear.
Figuras y tablas -
Analysis 2.13

Comparison 2 Puerperal outcomes, Outcome 13 No episiotomy wound ‐ no further tear.

Comparison 2 Puerperal outcomes, Outcome 14 No episiotomy wound ‐ further tear: 1st degree tear.
Figuras y tablas -
Analysis 2.14

Comparison 2 Puerperal outcomes, Outcome 14 No episiotomy wound ‐ further tear: 1st degree tear.

Comparison 2 Puerperal outcomes, Outcome 15 Episiotomy wound ‐ no further tear.
Figuras y tablas -
Analysis 2.15

Comparison 2 Puerperal outcomes, Outcome 15 Episiotomy wound ‐ no further tear.

Comparison 2 Puerperal outcomes, Outcome 16 Episiotomy wound ‐ further tear: 3rd degree tear.
Figuras y tablas -
Analysis 2.16

Comparison 2 Puerperal outcomes, Outcome 16 Episiotomy wound ‐ further tear: 3rd degree tear.

Comparison 2 Puerperal outcomes, Outcome 17 Intrapartum infection rates.
Figuras y tablas -
Analysis 2.17

Comparison 2 Puerperal outcomes, Outcome 17 Intrapartum infection rates.

Comparison 3 Labour duration, Outcome 1 Duration of labour (minutes).
Figuras y tablas -
Analysis 3.1

Comparison 3 Labour duration, Outcome 1 Duration of labour (minutes).

Comparison 3 Labour duration, Outcome 2 Second stage of labour duration.
Figuras y tablas -
Analysis 3.2

Comparison 3 Labour duration, Outcome 2 Second stage of labour duration.

Comparison 4 Level of satisfaction of parturients and medical staff (Likert scale), Outcome 1 Parturients' levels of satisfaction (Likert scale).
Figuras y tablas -
Analysis 4.1

Comparison 4 Level of satisfaction of parturients and medical staff (Likert scale), Outcome 1 Parturients' levels of satisfaction (Likert scale).

Comparison 4 Level of satisfaction of parturients and medical staff (Likert scale), Outcome 2 Labour attendants' levels of satisfaction (Likert scale).
Figuras y tablas -
Analysis 4.2

Comparison 4 Level of satisfaction of parturients and medical staff (Likert scale), Outcome 2 Labour attendants' levels of satisfaction (Likert scale).

Comparison 4 Level of satisfaction of parturients and medical staff (Likert scale), Outcome 3 Accoucheurs' levels of satisfaction (Likert scale).
Figuras y tablas -
Analysis 4.3

Comparison 4 Level of satisfaction of parturients and medical staff (Likert scale), Outcome 3 Accoucheurs' levels of satisfaction (Likert scale).

Comparison 4 Level of satisfaction of parturients and medical staff (Likert scale), Outcome 4 Perineorrhaphy operators' levels of satisfaction (Likert scale).
Figuras y tablas -
Analysis 4.4

Comparison 4 Level of satisfaction of parturients and medical staff (Likert scale), Outcome 4 Perineorrhaphy operators' levels of satisfaction (Likert scale).

Comparison 4 Level of satisfaction of parturients and medical staff (Likert scale), Outcome 5 Faecal soiling at delivery.
Figuras y tablas -
Analysis 4.5

Comparison 4 Level of satisfaction of parturients and medical staff (Likert scale), Outcome 5 Faecal soiling at delivery.

Comparison 1. Newborn outcomes

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Infection in newborns Show forest plot

1

222

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.31, 2.56]

2 Umbilical infection of the newborn Show forest plot

2

592

Risk Ratio (M‐H, Fixed, 95% CI)

3.16 [0.50, 19.82]

3 Neonatal infection at 4 days Show forest plot

1

1027

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Infection in newborns during the first month of life Show forest plot

1

370

Risk Ratio (M‐H, Fixed, 95% CI)

1.12 [0.76, 1.67]

5 Dacriocistitis or conjunctivitis (first month) Show forest plot

1

370

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.62, 1.71]

6 Skin infection (first month) Show forest plot

1

370

Risk Ratio (M‐H, Fixed, 95% CI)

1.60 [0.27, 9.47]

7 Upper respiratory tract infection during first month Show forest plot

1

369

Risk Ratio (M‐H, Fixed, 95% CI)

1.82 [0.73, 4.52]

8 Lower respiratory tract infection during first month Show forest plot

1

369

Risk Ratio (M‐H, Fixed, 95% CI)

0.10 [0.01, 1.73]

9 Newborn required systemic antibiotics after hospital discharge during the first month Show forest plot

1

367

Risk Ratio (M‐H, Fixed, 95% CI)

0.21 [0.03, 1.80]

10 Intestinal infection Show forest plot

1

368

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.07, 16.94]

11 Meningitis Show forest plot

1

370

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12 Sepsis Show forest plot

1

370

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 First minute Apgar < 7 Show forest plot

1

431

Risk Ratio (M‐H, Fixed, 95% CI)

1.31 [0.57, 3.06]

14 Five minute Apgar < 7 Show forest plot

1

431

Risk Ratio (M‐H, Fixed, 95% CI)

1.31 [0.57, 3.06]

Figuras y tablas -
Comparison 1. Newborn outcomes
Comparison 2. Puerperal outcomes

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Perineal tear: skin or superficial tissue without compromising muscle Show forest plot

2

1448

Risk Ratio (M‐H, Fixed, 95% CI)

1.14 [0.76, 1.71]

2 Perineal tear: perineal muscle without anal muscles Show forest plot

1

421

Risk Ratio (M‐H, Fixed, 95% CI)

0.72 [0.37, 1.40]

3 Perineal tear: compromises anal muscles but not the mucosa Show forest plot

2

1448

Risk Ratio (M‐H, Fixed, 95% CI)

0.46 [0.13, 1.64]

4 Perineal tear: complete tear that compromises anal mucosa Show forest plot

1

421

Risk Ratio (M‐H, Fixed, 95% CI)

2.93 [0.12, 71.51]

5 Infections during puerperium Show forest plot

2

594

Risk Ratio (M‐H, Fixed, 95% CI)

0.66 [0.42, 1.04]

5.1 First 24 hours by interview

1

222

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 Infection during the first month

1

372

Risk Ratio (M‐H, Fixed, 95% CI)

0.66 [0.42, 1.04]

6 Episiotomy dehiscence Show forest plot

1

372

Risk Ratio (M‐H, Fixed, 95% CI)

0.69 [0.41, 1.14]

7 Urinary tract infection Show forest plot

1

372

Risk Ratio (M‐H, Fixed, 95% CI)

0.60 [0.18, 2.00]

8 Pelvic infection: infected episiotomy Show forest plot

1

372

Risk Ratio (M‐H, Fixed, 95% CI)

0.60 [0.18, 2.00]

9 Pelvic infection: vulvovaginitis Show forest plot

1

372

Risk Ratio (M‐H, Fixed, 95% CI)

0.15 [0.01, 2.87]

10 Pelvic infection: endometritis Show forest plot

1

372

Risk Ratio (M‐H, Fixed, 95% CI)

0.26 [0.03, 2.31]

11 Pelvic infection: myometritis Show forest plot

1

372

Risk Ratio (M‐H, Fixed, 95% CI)

3.13 [0.13, 76.37]

12 Needed postpartum systemic antibiotics Show forest plot

1

428

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [0.73, 1.84]

13 No episiotomy wound ‐ no further tear Show forest plot

1

1027

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.43, 1.27]

14 No episiotomy wound ‐ further tear: 1st degree tear Show forest plot

1

1027

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [0.63, 2.19]

15 Episiotomy wound ‐ no further tear Show forest plot

1

1027

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.98, 1.05]

16 Episiotomy wound ‐ further tear: 3rd degree tear Show forest plot

1

1027

Risk Ratio (M‐H, Fixed, 95% CI)

0.21 [0.01, 4.38]

17 Intrapartum infection rates Show forest plot

1

152

Risk Ratio (M‐H, Fixed, 95% CI)

4.62 [1.03, 20.68]

Figuras y tablas -
Comparison 2. Puerperal outcomes
Comparison 3. Labour duration

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Duration of labour (minutes) Show forest plot

2

1179

Mean Difference (IV, Random, 95% CI)

28.04 [‐131.01, 187.10]

2 Second stage of labour duration Show forest plot

1

347

Mean Difference (IV, Fixed, 95% CI)

5.20 [‐2.56, 12.96]

Figuras y tablas -
Comparison 3. Labour duration
Comparison 4. Level of satisfaction of parturients and medical staff (Likert scale)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Parturients' levels of satisfaction (Likert scale) Show forest plot

1

1027

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.10, 0.10]

2 Labour attendants' levels of satisfaction (Likert scale) Show forest plot

1

1027

Mean Difference (IV, Fixed, 95% CI)

0.17 [0.08, 0.26]

3 Accoucheurs' levels of satisfaction (Likert scale) Show forest plot

1

1027

Mean Difference (IV, Fixed, 95% CI)

0.26 [0.15, 0.37]

4 Perineorrhaphy operators' levels of satisfaction (Likert scale) Show forest plot

1

1027

Mean Difference (IV, Fixed, 95% CI)

0.11 [0.02, 0.20]

5 Faecal soiling at delivery Show forest plot

1

152

Risk Ratio (M‐H, Fixed, 95% CI)

0.36 [0.17, 0.75]

Figuras y tablas -
Comparison 4. Level of satisfaction of parturients and medical staff (Likert scale)