Differences in episiotomy technique between midwives and midwifery and medical students

Abstract

• BACKGROUND: Episiotomy is the incision of perineum made to facilitate childbirth. Here are the two types of episiotomy: median and mediolateral. Considering 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, this study investigated the comparison episiotomy in midwives and midwifery and medical students in maternity ward of hospitals of Mashhad University of Medical Sciences.
• 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 was begun, 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 more angled than those drawn by students (P = 0.04) and median distance of the episiotomy from the midline in episiotomies drawn 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. The differences demonstrated could predispose mothers to a greater risk of anal sphincter injuries and subsequence complications in child birth.
• KEY WORDS: Episiotomy, midwife, medical student, normal vaginal delivery, perineum injury.