Prevalence and predictors of episiotomy among puerperal women accessing postnatal care in the Kumasi Metropolis.

BMC Pregnancy Childbirth

Department of Maternal and Child Health, School of Nursing and Midwifery, College of Health and Allied Sciences, University of Cape Coast, PMB, Cape Coast, Ghana.

Published: November 2024

AI Article Synopsis

  • - The study examined the prevalence of episiotomy among new mothers in Kumasi, finding that 49.7% had the procedure, significantly higher than the WHO's recommended rate of 10%.
  • - Factors like age, education, previous deliveries, and household income were linked to the likelihood of having an episiotomy, with married women and those attending more prenatal care sessions being less likely to undergo the procedure.
  • - The researchers concluded that the high rate of episiotomy suggests overuse, and recommended policy changes and better midwifery education to promote respectful maternity care and reduce unnecessary procedures.

Article Abstract

Background: This study investigated the prevalence and predictors of episiotomy among puerperal women accessing postnatal care in the Kumasi Metropolis.

Methods: A cross-sectional survey was conducted among 1750 postnatal mothers who had spontaneous vaginal using a questionnaire. Descriptive statistics were conducted to show the rate of episiotomy. Chi-square and binary logistic regression analyses were conducted using Jamovi software version 2.5.3.

Results: The prevalence of episiotomy among the study population was 49.7% compared to the 10% of all deliveries recommended by World Health Organisation (WHO). Among those who had an episiotomy, 88.5% gave consent, and 77.6% required repairs. In the bivariate analysis educational status, age, perineal tearing, marital status, household monthly income, spontaneous vaginal deliveries and previous episiotomy had a significant association with episiotomy risk. In the multivariate analysis, married women, lower education levels, moderate household incomes, grand multiparous women, spontaneous vaginal delivery (SVD), instrumental deliveries, longer second stages of labour, and attending more antenatal care (ANC) sessions were all associated with a reduced likelihood of episiotomy. Higher one-minute Apgar scores and anemia also lowered the odds. Conversely, hypertensives, women with four or more previous vaginal deliveries, and those with a history of episiotomy were more likely to undergo the procedure.

Conclusion: Episiotomies conducted was high, indicating potential overuse compared to WHO's recommendations. Antenatal attendance and timing should be prioritised to improve maternal preparation and outcomes. Policy interventions to reduce unnecessary episiotomies are needed. Midwifery education must also emphasise the importance of respectful maternity care.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566400PMC
http://dx.doi.org/10.1186/s12884-024-06967-1DOI Listing

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