Knowledge, attitude and experience of episiotomy practice among obstetricians and midwives in Jordan

Khresheh, Reham; Barclay, Lesley

doi:10.1016/j.wombi.2019.03.007

Cited by 9 publications

(22 citation statements)

References 18 publications

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“…22 for the perineum to stretch (56.6%) as a reason for doing it. 25 In Cambodia a study reveals that; lack of time in overcrowded delivery rooms, a reason for doing it. 26 The same reason was cited in a study about quality of maternity care practices among skilled birth attendants , that mention ,episiotomy was performed in order to accelerate the delivery, given the high number of women in the labor ward.…”

Section: Discussionmentioning

confidence: 99%

“…24 In another study most common midwife-reported reason for episiotomy among women was primiparity (55.1 %) All women with episiotomy sustained at least a second-degree perineal tear versus 27.1 % among women without episiotomy. 25 InCambodia a study reveals that; episiotomy performed with high rate (94.5%), due to various reasons include, fear of perineal tears and lack of time in overcrowded delivery rooms. 26 The same reason was cited in a study about quality of maternity care practices among skilled birth attendance that performed an episiotomy in order to accelerate the delivery, given the high number of women in the labor ward.…”

Section: Introductionmentioning

confidence: 99%

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Midwives’ Perceptions, Experience and Reasonsfor Routine Episiotomy in Maternity Teaching Hospitals - Khartoum State- Sudan

Faiza Ali Nasor Taha

2021

IJONE

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Background: Midwives have a crucial role in caring for women with normal labor. Routine episiotomy has no benefit and its used is not scientifically supported. Understanding midwives' perception and experiences would target the situation.This study aimed to explore midwives' perceptions,experience and reasons for routine episiotomy. Methods:A cross-sectional exploratory study was conductedin three maternity teaching hospitals in Khartoum state on 85 midwives recruited randomly and consented to take part in the study. A questionnaire was constructed for the purpose of the study, and data were collected by interview with midwives, on reasons for and rate of episiotomy and perceptions of midwives were recorded on a Likert scale. Suitable statistical methods were used. Results:A high percentage of the study participants 64(75.4%) were nurse midwives had a midwifery certificate. With long years of experience more than ten years 54 (63.5%).The rate of episiotomies was high 73(85.9%).The midwives reported nine clinical reasons , mainly preventscomplications, Prevents the perineum tears and helping birth (93%, 90%, 84.7%) respectively.Midwives perceived that; episiotomy "speeds up the second stage of labor", "prevent perineal tears and urinary and fecal incontinence", "Reduces fetal and maternal distress",shoulder dystociacomplications, bleeding,labor pain, instrument-assisted delivery and allow for easier suturing".There was a significant correlation between Midwives practice and their education with, P value =.001. Conclusion:The rate of routine episiotomy was high with Midwives misleading perspectives and views

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Midwives’ Perceptions, Experience and Reasonsfor Routine Episiotomy in Maternity Teaching Hospitals - Khartoum State- Sudan

Faiza Ali Nasor Taha

2021

IJONE

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“…This questionnaire was developed from literature review and expert panel advice, 2 31-33 and the questions had been used in previous studies. 27 34 The questionnaire was initially drafted in English and then underwent the 'forward-backward-forward' translation from English to Chinese and then to English again by another translator from the School of Languages, Zhengzhou University. A bilingual expert did the translation to maintain content meaning over a word-for-word literal translation.…”

Section: Datamentioning

confidence: 99%

“…The third part collected knowledge related to the outcomes of routine use of episiotomy. These questions had been used in previous studies, 27 34 including the risk of postpartum haemorrhage, neonatal distress, wound healing/complications, perineal pain, urinary incontinence and pelvic organ prolapse. The fourth part collected data about participants' attitudes towards episiotomy using questions derived from related sections in previous studies.…”

Section: Datamentioning

confidence: 99%

“…The fourth part collected data about participants' attitudes towards episiotomy using questions derived from related sections in previous studies. 27 34 These included views on the average rate of episiotomy of delivery units in Henan Province (too high, too low, about right), appropriateness of routine episiotomy policy for nulliparous and multiparous women, and perceived barriers to reducing rate of episiotomy.…”

Section: Datamentioning

confidence: 99%

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Knowledge, attitude and experience of episiotomy practice among obstetricians and midwives: a cross-sectional study from China

Yang

Bai

2021

BMJ Open

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ObjectiveEpisiotomy is still performed widely by obstetricians and midwives in some Chinese maternity units, but the reasons are unknown. This study aims to determine the knowledge, attitude and experience towards the practice of episiotomy among obstetricians and midwives in China’s public hospitals and consider strategies to reduce its practice.MethodsA cross-sectional web survey using a self-administered questionnaire was conducted among obstetricians and midwives in 90 public hospitals in Henan Province, China.Results900 (82.21%) participants completed the questionnaire. Average knowledge level (4.15, SD=1.10) on complications and overuse was identified among participants. Episiotomy was performed more frequently in secondary hospitals than in tertiary hospitals (p<0.05). Senior clinicians were more likely to perform episiotomy than younger ones (p<0.05). Almost half of the clinicians (42.11%) considered the current rate of episiotomy (45%) to be right or too low. The most common reason for performing episiotomy identified by obstetricians (83.94%) and midwives (79.69%) was to reduce third-degree or fourth-degree perineal laceration. Both obstetricians (80.29%) and midwives (82.57%) agreed that the most significant obstacle to reducing the rate of episiotomy was lack of training on reducing perineal tears.ConclusionIn sum, episiotomy was driven by previous training, practitioners’ experience and local norms rather than the latest medical evidence. Clinicians in secondary hospitals and senior clinicians are key training targets. It is urgent to improve current clinical policies and surgical procedure guidelines for obstetricians and midwives regarding episiotomy.

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Low-Value Surgical Procedures in Low- and Middle-Income Countries

Albarqouni,

Abukmail,

MohammedAli

et al. 2023

JAMA Netw Open

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ImportanceOveruse of surgical procedures is increasing around the world and harms both individuals and health care systems by using resources that could otherwise be allocated to addressing the underuse of effective health care interventions. In low- and middle-income countries (LMICs), there is some limited country-specific evidence showing that overuse of surgical procedures is increasing, at least for certain procedures.ObjectivesTo assess factors associated with, extent and consequences of, and potential solutions for low-value surgical procedures in LMICs.Evidence ReviewWe searched 4 electronic databases (PubMed, Embase, PsycINFO, and Global Index Medicus) for studies published from database inception until April 27, 2022, with no restrictions on date or language. A combination of MeSH terms and free-text words about the overuse of surgical procedures was used. Studies examining the problem of overuse of surgical procedures in LMICs were included and categorized by major focus: the extent of overuse, associated factors, consequences, and solutions.FindingsOf 4276 unique records identified, 133 studies across 63 countries were included, reporting on more than 9.1 million surgical procedures (median per study, 894 [IQR, 97-4259]) and with more than 11.4 million participants (median per study, 989 [IQR, 257-6857]). Fourteen studies (10.5%) were multinational. Of the 119 studies (89.5%) originating from single countries, 69 (58.0%) were from upper-middle–income countries and 30 (25.2%) were from East Asia and the Pacific. Of the 42 studies (31.6%) reporting extent of overuse of surgical procedures, most (36 [85.7%]) reported on unnecessary cesarean delivery, with estimated rates in LMICs ranging from 12% to 81%. Evidence on other surgical procedures was limited and included abdominal and percutaneous cardiovascular surgical procedures. Consequences of low-value surgical procedures included harms and costs, such as an estimated US $3.29 billion annual cost of unnecessary cesarean deliveries in China. Associated factors included private financing, and solutions included social media campaigns and multifaceted interventions such as audits, feedback, and reminders.Conclusions and RelevanceThis systematic review found growing evidence of overuse of surgical procedures in LMICs, which may generate significant harm and waste of limited resources; the majority of studies reporting overuse were about unnecessary cesarean delivery. Therefore, a better understanding of the problems in other surgical procedures and a robust evaluation of solutions are needed.

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Knowledge, attitude and experience of episiotomy practice among obstetricians and midwives in Jordan

Cited by 9 publications

References 18 publications

Midwives’ Perceptions, Experience and Reasonsfor Routine Episiotomy in Maternity Teaching Hospitals - Khartoum State- Sudan

Midwives’ Perceptions, Experience and Reasonsfor Routine Episiotomy in Maternity Teaching Hospitals - Khartoum State- Sudan

Knowledge, attitude and experience of episiotomy practice among obstetricians and midwives: a cross-sectional study from China

Low-Value Surgical Procedures in Low- and Middle-Income Countries

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