Differences in episiotomy technique between midwives and midwifery and medical students

BACKGROUND: Episiotomy is the incision of perineum made to facilitate childbirth. Two types of episiotomy are the median and the mediolateral. This study compared episiotomy in midwives, midwifery students and medical students in maternity ward of hospitals of Mashhad University of Medical Sciences with regard to the important role of incision characteristics such as length, angle and distance of initiation point from midperineum line in prevention of perineal rupture and reduction of further complications. METHODS: In this descriptive cross-sectional study, 127 midwives and midwifery and medical students completed the novel validated pictorial questionnaire. The length of episiotomy drawn, the distance from the sagittal plane at which the episiotomy began, and the angle of the episiotomy from the sagittal plane were evaluated. RESULTS: Median length of the episiotomy from the midline was 2.89 ± 0.95 cm. Episiotomies drawn by midwives angled more than those drawn by students (p = 0.04) and median distance of the episiotomy from the midline in episiotomiesdrawn by students were significantly more than those drawn by midwives (p = 0.0001). CONCLUSIONS: This study demonstrated some differences in the episiotomy practice by midwives and midwifery and medical students. These differences can predispose mothers to a greater risk of anal sphincter injuries and subsequently complications in child birth.