Factors Associated with Episiotomy Practices in Bahirdar City, Ethiopia: A Cross-Sectional Study

Abstract

Background

Episiotomy is the surgical enlargement of the vaginal orifice during the last part of the second stage of labor or childbirth by an incision to the perineum. The World Health Organization advises the use of episiotomy on a restricted and selective basis. Indeed, the rate of episiotomy in developed countries is decreasing, but in developing countries, including Ethiopia, it still remains high. Therefore, this study tried to assess the proportion and factors associated with episiotomy among women who gave birth at Felege Hiwot Referral Hospital, Bahir Dar City, North West Ethiopia, 2017.

Methods

An institution-based cross-sectional study was conducted among 411 mothers from February to April 2017. Data were collected through face-to-face interviews and supported by observation using standard checklist with systematic random sampling technique. Data was entered by Epi Info and analyzed by SPSS version 23. The association between variables was analyzed using bivariable and multivariable logistic regression model. P-value <0.05 at 95% CI was considered to be statistically significant.

Results

The proportion of episiotomy was 41.1% with 95% CI (36.5%, 46.2%). Multivariable logistic regression showed that primiparity (AOR=6.026, 95% CI (3.542,10.253)), prolonged second stage of labor (AOR=4.612, 95% CI (2.247,9.465)), instrument delivery (AOR =3.933, 95% CI (1.526,10.141)), using oxytocin (AOR=2.608, 95% CI (1.431,4.751)), medical resident attendant (AOR =3.225, 95% CI (1.409,7.382)) and birth weight ≥4000 grams (AOR=5.127,95% Cl (1.106,23.772)) were significantly associated with episiotomy practice.

Conclusion

The proportion of episiotomy was high. Parity, using oxytocin, second-stage labor duration, instrument delivery, birth weight, and delivery attendant were statistically significant factors for episiotomy practice. Therefore, as per our findings, we suggest awareness creation, and the setting and use of new national guidelines, the practice of routine episiotomy should be abandoned, and selective and restrictive use of episiotomy is highly advised.

Keywords:

• episiotomy
• women
• Bahir Dar
• Ethiopia

Acknowledgment

We would like to acknowledge Bahir Dar University, College of Medicine and Health Sciences, Ethiopia for granting us the permission to conduct this research. We are also obliged to thank data collectors, study participants and supervisors for their commitment to take part in the study.

We also thank EPHA for the selection of the paper as poster presentation in the 29 EPHA Annual Conferences and posted online for readers. The abstract of this paper was presented at the 29th EPHA Annual Conference as a poster presentation. The abstract of this paper was realized/posted online and available at: http://www.etpha.org/conference/index.php/29thConference/29thConference/paper/view/1042

Abbreviations

ANC, ante natal care; APGAR, Appearance, Pulse, Grimace, Activity, Respiration; WHO, World Health Organization.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon request.

Author Contributions

All authors made substantial contributions to conception, study design, execution, and acquisition of data, analysis and interpretation; drafting, revising or critically reviewing the article; journal selection for publication, gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests.

Additional information

Funding

Bahir Dar University, the funder organization covered the costs of data collectors and supervisors per-diem. Otherwise they had no role in designing the study, manuscript preparation or for publication cost.