The proportion of Episiotomy and Associated Factors among Mothers Who Gave Birth at Public Institutions, Northwest Ethiopia: A cross-sectional study

Abstract

Abstract Background Episiotomy is the surgical enlargement of the posterior aspect of the vagina by an incision made on the perineum during the last phase of the second stage of labor. The rate of episiotomy is on the decline in developed countries but remains high in less industrialized countries. Studies are limited to showing the extent of the problem and the reasons behind episiotomy practice. The objective of this study was to assess the proportion of episiotomy practice and its associated factors among mothers who gave birth at public health institutions in Debark town, Northwest Ethiopia. Methods Institutional based cross-sectional study was conducted among 410 mothers who gave birth from 1 April 2021 to 30 June 2021 in Debark town. A systematic random sampling technique was used to select study participants. Data were entered into Epi data version 3.1, coded, cleaned, and then exported to SPSS version 23 for analysis. Variables with p-value < 0.25 during the bivariable analysis were considered for multivariable logistic regression analysis. Stepwise backward elimination was done to select variables associated with episiotomy and Hosmer and Lemeshow test was used to check model fitness. Adjusted odds ratio with a 95% confidence interval and a p-value < 0.05 was used to decide the association of independent variables with the outcome variable. Results The proportion of episiotomy among the study participants was 42.9% (95% CI; 38–48%). Face presentation (AOR = 4.15; 95% CI (1.22,14.1) P = 0.02), Previous episiotomy (AOR = 3.73; 95% CI (1.95,7.15); P < 0.001), Short birth spacing interval (AOR = 1.66;95% CI (1.01,2.73); P = 0.04), perineal laceration (AOR = 2.18; 95% CI (1.16,4.08); P = 0.014) and induced labor (AOR = 2.12; 95% CI (1.08, 4.14); P = 0.028) were significantly associated with episiotomy. Conclusions The prevalence of episiotomy in the study area is high. It is significantly associated with face presentation, short birth spacing interval, induced labor, perineal tear, and previous episiotomy. In the presence of the aforementioned factors, judicious use of episiotomy is warranted.