Episiotomy at Public Health Institutions in Hosaena Town, Southern Ethiopia: An Institution-Based Cross-Sectional Study

BACKGROUND: Episiotomy was first suggested about two centuries back to prevent perineal tear as well as a fetal head injury. However, there have been controversies about its benefits over its side effects. The magnitude of episiotomy varies across the world. No study was conducted in the study area. This study was aimed at assessing the magnitude and factors associated with episiotomy at public health institutions. SUBJECTS AND METHODS: Institutional-based cross-sectional study design was employed in four public health institutions in Hosaena Town. Data were collected through interviews administered structured questionnaires and supplemented with maternal chart review and anthropometric measurement from May 1st to June 30th, 2019. Study participants were selected using a systematic random sampling technique. EpiData 3.02 and SPSS version 21 software were used for data entry, and analysis, respectively. Descriptive statistics, bivariate and multivariable logistic regression analysis were done. Variables at p-value < 0.2 were transferred to multivariable logistic regression analysis. Then variables at p-value <0.05with 95% CI were considered as statistically significant and AOR was used to interpret factors associated with episiotomy. Tables and graphs have been used to present the results. RESULTS: A total of 410 delivered mothers were included in the study and the magnitude of episiotomy was 57.6%with a mean of 95% CI = 0.53-0.63.Being primiparous (AOR = 16.96, 95% CI: 9.26, 31.05), meconium-stained amniotic fluid (AOR = 3.82, 95% CI: 1.84, 7.96), Second stage of labor lasting more than 2 hours (AOR = 2.43, 95% CI: 1.11, 5.32), births attended by non-midwife professionals (AOR = 2.26, 95% CI: 1.24, 4.14) and newborns head circumference >35 cm (AOR = 5.73, 95% CI: 3.29, 10.00) were factors significantly associated with episiotomy. CONCLUSIONS: Episiotomy was performed in more than half of the mothers included in the study. All the responsible bodies from the administrative to clinical practitioners should be in action to lower the magnitude of episiotomy by assuring that it is practiced restrictively with scientific indications.