Midwives' perception on the use of episiotomy.

Abstract

The use of episiotomy is part of the midwifery practice since from the 1960's. The perceptions on its use have always been questioned ever since it has been used in midwifery. Locally episiotomy is used according to the situations, that is, selectively and there are no protocols that indicate routine episiotomy with every normal delivery. The use of episiotomy in the presence of fetal distress has been always a justificable indication (Sleep, 1990). The main aim of the study was to investigate midwives' perceptions on the use of episiotomy. A descriptive non-experimental design was used and data was collected by means of structured interviews using open-ended questions. The sample comprised ten midwives (n=10) from the labour ward at one of the local hospitals. From this study it was found that midwives regarded that the most important indications for an episiotomy are, fetal distress, preterm deliveries and big babies. Midwives also perceived that the risks of episiotomy are excessive bleeding, breakdown of sutures and more pain when compared to perineal tears. Midwives identified that when choosing between having perineal tears and episiotomies during deliveries, they preferred perineal tears, as these are less painful than episiotomies, they involve less muscle tissues of the perineal area and they can be superficial such as first degree tears. Due to the small size of the sample, the results cannot be generalised for the whole population of midwives working in the Labour Ward.