Knowledge and Perception of Pregnant Women to Episiotomy in Ibadan
Introduction
Episiotomy, the surgical incision made to widen the perineum in order to facilitate vaginal delivery and prevent laceration, has been part of obstetrics practice since 1920s . although said to have been reported as far back as 1741 .Primigravidity and operative vaginal deliveries have been associated with higher incidence of episiotomy and while routine use with its attendant complications have continued unabated, restrictive use recommended by WHO has been difficult to achieve in many developing countries. Randomized controlled trials comparing routine with restrictive use of episiotomy during spontaneous vaginal birth suggested that adopting a restrictive policy offers significant benefits to the parturient especially a reduction in the risk of posterior perineal tears .
It has been shown that women were offered little or no information by healthcare professionals on the essence of episiotomy while the parturients’ level of awareness of episiotomy has not been well documented in our environment as earlier emphasis were focused on indications and complications . Documented complications of episiotomy include post-episiotomy discomfort, infection and sexual dysfunction . However, the goal of informed choice ensures that pregnant women are provided with comprehensive information about their care in order to facilitate appropriate and informed decisions .
A greater understanding of implication of episiotomy from the perspective of the women will assist in improving the quality of care in the postpartum period for those who underwent the procedure. This study was therefore aimed to provide information on what women know and perceive about episiotomy and determine the possible factors that influence their attitude towards it.
Methodology
This is a descriptive cross-sectional survey conducted among pregnant women within Ibadan metropolis over an 8-week period. Consenting pregnant women in the antenatal clinics of the University College Hospital, Ibadan – a tertiary level health care centre, and Adeoyo Maternity Hospital, Yemetu, Ibadan (providing secondary level care) were enrolled into the study. Ethics approval was obtained from the Oyo state ethics committee. Data were collected using structured interviewer-administered questionnaire with both open and closed ended questions. Information obtained using set questions on the questionnaire included: the respondents’ sociodemographic characteristics (by asking questions on age, marital status, level of education, tribe and occupation); knowledge about episiotomy and the source(s) of information; personal experiences of episiotomy including indication, the accoucheurs as well as complications if any; acceptability of episiotomy to the respondents as well as opinion about health workers’ attitude towards performing episiotomy.
The data were coded, cleaned and checked for completeness. Frequencies, proportions and percentages were generated for socio-demographic variables and variables under the knowledge and attitudes of pregnant women to episiotomy. Chi square tests were used to determine associations and odds ratio with confidence intervals were calculated for risks while p-value less than 0.05 was set as statistically significant. Statistical analysis was done using SPSS version 18.0 (Chicago, IL, USA).
Results
Three hundred and four (304) pregnant women, with mean age 29.6±4.8 years, satisfactorily responded to the survey, out of which 199 (65.5%) had ever heard about episiotomy.
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