Prevalence and factors associated with episiotomy among women in Eastern Uganda: A cross-sectional study

Abstract Background : The World Health Organization recommends episiotomy rates of about 10–15%. However, studies in Uganda have reported higher episiotomy rates than the WHO-recommended rate. Higher episiotomy rates may suggest overmedicalization of childbirth. The study was conducted to determine the prevalence and factors associated with episiotomy in our setting. Methods : A cross-sectional study was conducted in a tertiary hospital in Eastern Uganda. We recruited 370 women who had uncomplicated vaginal birth. Participants were recruited during discharge from the postnatal unit of the hospital. An interviewer-administered questionnaire was used for data collection. Logistic regression analyses were used to assess factors associated with episiotomy. Results : Nearly a third (29.7%, n = 110/370) of women sustained perineal tears during childbirth. The prevalence of episiotomy was 11.6% (43/370). The factors associated with the practice of episiotomy were the birth attendant being a doctor (adjusted odds ratio [AOR] = 4.28; 95% CI: 1.36–13.44), multiparity (AOR = 0.01; 95% CI: 0.03–0.34), increasing fetal head circumference (AOR = 1.51; 95% CI: 1.04–2.20), having perineal tears (AOR = 0.16; 95% CI: 0.06–0.48), and labor augmentation (AOR = 2.92; 95% CI: 1.14–7.48). Conclusion : Episiotomy rates were within the WHO-recommended range. Episiotomy was associated with parity, type of birth attendant, fetal head circumference, perineal tears, and use of labor augmentation.