Women’s Involvement in Decision Making: Episiotomy Procedure

Abstract

Background: Involving patient in decision making for their care can enhance satisfaction and promote health outcomes in particular in the nursing fields. As The World Health Organization Principles of Perinatal Care has recommended that care should involve women in decision making. This principle strongly endorses for improving effective perinatal care. Decision making regard to treatment options is a concept that has increased widespread appeals to healthcare providers and users in recent year. Evidently, patient involvement in decision making has not always been implemented in clinical practice in particular during intrapartum period. Objective: The aim of this study was to investigate the involvement of women in decision making on episiotomy procedure during labor. Methods: A descriptive quantitative approach was conducted using self-administered survey questionnaires in two government hospitals, Bangkok, Thailand. Participating hospitals were identified by convenience and remained anonymous. The Participant, eligible women included those who have reached 37 to 42 weeks of gestation, experienced vaginal birth, have a live baby, and admitted in the postpartum units. An appropriate sample size was assigned based on a 95 percent confidence level. A sample size was drawn from two hospitals based on a binomial probability distribution. There were 400 postpartum women participated in this study. Anonymous patient’s data were analyzed using frequencies and percentages. Results: The results revealed that 80% of all women experienced episiotomy. The finding demonstrated that decision making on having this procedure made by health care providers and relatives 73.8%, 3.2%, respectively. 23% of them had a chance to make a decision on having episiotomy. There were 23.8% of women received information about risks and benefits of episiotomy procedure and 76.2% did not get information. Conclusion: The findings of this study demonstrated that women have less opportunity to make a decision on having episiotomy during labor and received less information about this procedure. Therefore, health care providers should be clearly discussed about risks and benefits of episiotomy before performing the procedure. The factors influencing patient involvement in decision making should be investigated to promote good experiences of women during delivery and increase satisfaction toward their care.