BACKGROUND: To examine the episiotomy incidence and determinants and outcomes associated with its use in primary care midwifery practices. METHODS: Secondary analysis of two prospective cohort studies (n = 3,404). RESULTS: The episiotomy incidence was 10.8 percent (20.9% for nulliparous and 6.3% for parous women). Episiotomy was associated with prolonged second stage of labor (adj. OR 12.09 [95% CI 6.0-24.2] for nulliparous and adj. OR 2.79 [1.7-4.6] for parous women) and hospital birth (adj. OR 1.75 [1.2-2.5] for parous women). Compared with episiotomy, perineal tears were associated with a lower rate of postpartum hemorrhage in parous women (adj. OR 0.58 [0.4-0.9]). Fewer women with perineal tears reported perineal discomfort (adj. OR 0.35 [0.2-0.6] for nulliparous and adj. OR 0.22 [0.1-0.3] for parous women). Among nulliparous women episiotomy was performed most frequently for prolonged second stage of labor (38.8%) and among parous women for history of episiotomy or prevention of major perineal trauma (21.1%). CONCLUSIONS: The incidence of episiotomy is high compared with some low-risk settings in other Western countries. Episiotomy was associated with higher rates of adverse maternal outcomes. Restricted use of episiotomy is likely to be beneficial for women.
BACKGROUND: To examine the episiotomy incidence and determinants and outcomes associated with its use in primary care midwifery practices. METHODS: Secondary analysis of two prospective cohort studies (n = 3,404). RESULTS: The episiotomy incidence was 10.8 percent (20.9% for nulliparous and 6.3% for parous women). Episiotomy was associated with prolonged second stage of labor (adj. OR 12.09 [95% CI 6.0-24.2] for nulliparous and adj. OR 2.79 [1.7-4.6] for parous women) and hospital birth (adj. OR 1.75 [1.2-2.5] for parous women). Compared with episiotomy, perineal tears were associated with a lower rate of postpartum hemorrhage in parous women (adj. OR 0.58 [0.4-0.9]). Fewer women with perineal tears reported perineal discomfort (adj. OR 0.35 [0.2-0.6] for nulliparous and adj. OR 0.22 [0.1-0.3] for parous women). Among nulliparous women episiotomy was performed most frequently for prolonged second stage of labor (38.8%) and among parous women for history of episiotomy or prevention of major perineal trauma (21.1%). CONCLUSIONS: The incidence of episiotomy is high compared with some low-risk settings in other Western countries. Episiotomy was associated with higher rates of adverse maternal outcomes. Restricted use of episiotomy is likely to be beneficial for women.
Authors: Madhu Naidu; Dharmesh S Kapoor; Sarah Evans; Latha Vinayakarao; Ranee Thakar; Abdul H Sultan Journal: Int Urogynecol J Date: 2015-02-06 Impact factor: 2.894
Authors: Ank de Jonge; Lilian Peters; Caroline C Geerts; Jos J M van Roosmalen; Jos W R Twisk; Peter Brocklehurst; Jennifer Hollowell Journal: PLoS One Date: 2017-07-27 Impact factor: 3.240
Authors: Anna Seijmonsbergen-Schermers; Thomas van den Akker; Katrien Beeckman; Annick Bogaerts; Monalisa Barros; Patricia Janssen; Lorena Binfa; Eva Rydahl; Lucy Frith; Mechthild M Gross; Berglind Hálfdánsdóttir; Deirdre Daly; Jean Calleja-Agius; Patricia Gillen; Anne Britt Vika Nilsen; Eugene Declercq; Ank de Jonge Journal: BMJ Open Date: 2018-01-10 Impact factor: 2.692
Authors: Suzanne M Thompson; Marianne J Nieuwenhuijze; Luc Budé; Raymond de Vries; Lisa Kane Low Journal: BMC Pregnancy Childbirth Date: 2018-04-16 Impact factor: 3.007
Authors: Anna E Seijmonsbergen-Schermers; Dirkje C Zondag; Marianne Nieuwenhuijze; Thomas van den Akker; Corine J Verhoeven; Caroline C Geerts; François G Schellevis; Ank de Jonge Journal: PLoS One Date: 2020-03-05 Impact factor: 3.240
Authors: Anna Seijmonsbergen-Schermers; Suzanne Thompson; Esther Feijen-de Jong; Marrit Smit; Marianne Prins; Thomas van den Akker; Ank de Jonge Journal: BMJ Open Date: 2021-01-13 Impact factor: 2.692