Prevalence of Episiotomy and Factors Associated with Its Practice in Three Teaching Hospitals, Addis Ababa, Ethiopia

Abstract

Background: Episiotomy is a surgical incision into the perineum and posterior vaginal wall during the second stage of labor to increase the diameter of the soft tissue pelvic outlet to facilitate delivery. Episiotomy rates vary from population to population. Limited information exists related to the practice of episiotomy in Ethiopia. Objective: To assess the prevalence of episiotomy practice and associated factors at three teaching hospitals (Tikur Anbessa Hospital, Gandhi Memorial Hospital, and Zewditu Memorial Hospital) in Addis Ababa Ethiopia. Method and Materials: Hospital-based cross-sectional study was conducted from January 2022 to March 2022 on 386 mothers who had a vaginal delivery in the three hospitals. A structured questionnaire was used to collect data. The data was entered, coded, and analyzed using Statistical Package for Social Science (SPSS) version 25. Binary and multivariable logistic regression analyses were performed. P value ? 0.05 was used to determine the level of statistically significant variables. Results: The prevalence of episiotomy was 49%. Age ?24 years (AOR=0.17, 95%CI=0.055, 0.52), operative vagainal delivery (vacuum AOR=3.1, 95%CI=1.50,18.67 and forceps AOR=3.5, 95%CI=1.87, 11.06), duration of second stage of labor ?2HR (AOR=3.5, 95%CI=1.87, 11.06), birth weight of newborn ?4000 grams (AOR=5.3, 95%CI=95%CI, 1.28, 22.02) and FGM (AOR=2.8, 95%CI=1.64, 4.94) were factors significantly associated with episiotomy practice. Conclusion: The prevalence of episiotomy in this study (49%) is higher than the WHO’s recommendation (10%). Variables that remained associated significantly with episiotomy were maternal age, instrument delivery, duration of the second stage of labor ?2HR, newborn weighing ?4000 grams, and FGM. An effort should be made to reduce the prevalence of episiotomy by adhering to the correct indications and preparing periodic on-job training regarding the indication of episiotomy to all obstetric care providers.