A new study from Denmark has found that giving antibiotics to women shortly after childbirth can help lower the risk of serious wound problems.
The study, published in The BMJ, focused on women who experienced a second-degree tear or had an episiotomy during vaginal delivery—both of which are common childbirth injuries.
Second-degree tears affect the skin and muscles around the vagina and perineum, while an episiotomy is a surgical cut made during childbirth to help deliver the baby.
These types of tears happen to millions of women every year.
Doctors already know that antibiotics can help prevent infection after certain types of deliveries, like those using tools such as vacuum or forceps.
But until now, it hasn’t been clear whether antibiotics also help women who experience tears without needing those tools.
To find out, researchers in Copenhagen studied 442 women who gave birth vaginally between March and December 2023. All of them had a second-degree tear or an episiotomy.
Half of the women were given three doses of oral antibiotics within 24 hours after giving birth. The other half received a placebo (a fake treatment). The women were then checked for wound problems between four and 14 days later.
The researchers looked for two kinds of problems: overall wound complications (such as infections or wounds that opened up again), and clinically relevant complications—meaning those serious enough to require extra medical care.
The results showed that giving antibiotics didn’t reduce the total number of wound problems much. About 22% of the women who got antibiotics had some kind of complication, compared to 29% in the placebo group. That difference wasn’t large enough to be considered significant.
But when it came to clinically important problems, antibiotics did make a big difference. Only 9% of women in the antibiotic group had serious wound issues, compared to 17% in the placebo group. That means one serious wound problem could be prevented for every 12 women given antibiotics.
Women who got antibiotics also needed fewer extra antibiotic treatments later and said they felt better overall. No serious side effects were seen from the antibiotics.
The researchers say these results are important because they suggest that even women who aren’t at high risk of infection may still benefit from antibiotics after childbirth tears. The study was well-designed with a low drop-out rate and consistent testing, although the results may not apply to all women everywhere.
The researchers do note that more studies are needed to figure out exactly which women are most at risk of wound infections so that antibiotics can be used in the smartest way possible. Still, the study supports giving preventive antibiotics as part of regular care after a second-degree tear or episiotomy.
In summary, while antibiotics may not prevent all wound problems, they do seem to lower the chances of more serious, painful complications. This could mean better recovery and comfort for new mothers after childbirth.
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The study is published in The BMJ.
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