Midwives' management of episiotomy at a district general hospital

Abstract

Episiotomy used to be a popular procedure in obstetrics and was performed almost routinely to facilitate labour. Evidence now suggests that a episiotomy cut should only be performed if there is clinical need. Subsequently, episiotomy rates have dropped and midwives are less exposured to the procedure. This audit investigates midwives' training, clinical experience, technique, and confidence with regard to episiotomies. Over a 5-week period, questionnaires were completed by 66 midwives working at Sunderland Royal Hospital (SRH). It found that a large majority had received episiotomy training but fewer had been trained in episiotomy repair before registering with the Nursing and Midwifery Council (NMC). The description of the procedure varied, with the angle for an episiotomy cut suggested between 29° and 80° from the midline of the perineum. There is a reported lack of clinical experience, especially amongst junior midwives, and self-confidence varies considerably; with those who have been qualified the longest, claiming to be more confident in these procedures.