Abstract
Background Episiotomy is the most common obstetric procedure, performed when the clinical circumstances place the patient at a high risk of high-degree laceration. However, episiotomy should be done with judicious indication to lower perineal laceration with fewer complications. Despite its adverse effects, the magnitude of episiotomy is increasing due to different factors. Therefore, this study is aimed at determining the recent magnitude of episiotomy and at identifying associated factors among women who gave delivery in Arba Minch General Hospital, Southern Ethiopia. Methods An institution-based cross-sectional study was conducted from December 15, 2018, to January 30, 2019. A systematic random sampling technique was used to select study participants. A semistructured questionnaire was used to collect data. This was supplemented with a review of the labor and delivery records. Binary and multivariable logistic regression analyses were performed to identify factors associated with the magnitude of episiotomy. P value ≤ 0.05 was used to determine the level of statistically significant variables. Results The magnitude of episiotomy was found to be 272 (68.0%) with 95%CI = 64.0‐72.5. Women who attended secondary education [AOR = 10.24, 95%CI = 2.81‐37.34], women who attended college and above [AOR = 4.61, 95%CI = 1.27‐16.71], birth weight ≥ 3000 g [AOR = 4.84, 95%CI = 2.66‐8.82], primipara [AOR = 4.13, 95%CI = 2.40‐7.12], being housewife occupants [AOR = 3.43, 95%CI = 1.20‐9.98], married women [AOR = 2.86, 95%CI = 1.40‐5.84], and body mass index < 25 kg/m2 [AOR = 2.85, 95%CI = 1.50‐5.44] were independent variables found to have significant association with episiotomy. Conclusion The magnitude of episiotomy was 68.0% which is higher than the recommended practice by WHO (10%). The study participants' occupational status, marital status, educational status, parity, birth weight, and BMI were significantly associated with the magnitude of episiotomy in the study area. Therefore, to reduce the rate of episiotomy, it is better to have periodic training for birth attendants regarding the indication of episiotomy.
Highlights
Episiotomy is the most common obstetric procedure, performed when the clinical circumstances place the patient at a high risk of high-degree laceration
The American College of Obstetricians and Gynecologists (ACOG) and Federation of International Gynecology and Obstetricians recommend that episiotomy should be done with judicious indication to lower perineal laceration with fewer complications [3, 4]
This study is aimed at determining the recent magnitude of episiotomy and at identifying associated factors among women who gave delivery in Arba Minch General Hospital, Gamo Zone, southern Ethiopia, which may help to reduce adverse consequences to the mother
Summary
Episiotomy is the most common obstetric procedure, performed when the clinical circumstances place the patient at a high risk of high-degree laceration. The American College of Obstetricians and Gynecologists (ACOG) and Federation of International Gynecology and Obstetricians recommend that episiotomy should be done with judicious indication to lower perineal laceration with fewer complications [3, 4]. The finding from studies conducted in a different part of the world shows that episiotomy increases the risk of thirdand fourth-degree perineal lacerations which had short- and long-term complications for mothers [6,7,8]. A study conducted in Taiwan indicated that episiotomy increased the Journal of Pregnancy number of women who had pain at the first, second, and sixth weeks of postpartum and urinary incontinence [9]. Episiotomy use is associated with a higher incidence of perineal pain in the immediate postpartum period, where it predisposes them to risk of psychological morbidity and stress urinary incontinence in 6 weeks postpartum
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