Prevalence and Factors Associated With Episiotomy in Shahroud City, Northeast of Iran

Episiotomy is the most common surgical incision in midwifery. Given its questionable benefits, the present study aimed to determine the frequency of episiotomy and its associated factors in women with vaginal childbirth. Materials and Methods: This descriptive cross-sectional study was conducted on a population consisting of all women that had vaginal childbirth over a six-month period (from October 2014 to April 2015) in Fatemieh Teaching hospital in Shahroud city. Participants were selected by census. Data were collected using a researcher-made questionnaire consisting of four parts, whose validity and reliability had been confirmed. Data were analyzed in SPSS 21 using descriptive statistics and chi-square, t test and logistic regression analysis. Results: Of the 978 cases of vaginal childbirth, 406 (41.5%) had undergone episiotomy. Mean age of participating women was 27.32±5.14 years. Episiotomy was found to have significant relationships with mother’s age, parity, first and fifth minute Apgar scores, duration of the second stage of labor, birth spacing, use of oxytocin, vacuum deliveries and use of analgesics (P < 0.05). Overall, prevalence of intact perinea was 34.7%. In the final logistic regression analysis, among significant variables and variables with P<0.1 in univariate analysis, parity, use of oxytocin, first minute Apgar score and infant’s head circumference with P < 0.0001 and birth spacing with P = 0.043 were considered predictors of episiotomy. Conclusion: The overall rate of episiotomy in this study was 41.5%, which is much higher than the standards set by the World Health Organization (WHO). Further research is required to provide appropriate solutions to reduce episiotomy.