Episiotomy Practices and Associated Factors in Central Vietnam

Introduction Research on episiotomy practices in Vietnam is limited. This study aimed to describe episiotomy use and identify factors associated with its practice among vaginal births in Central Vietnam, following the implementation of restrictive episiotomy guidelines. Methods We used data from a hospital-based, retrospective study conducted at Danang Hospital for Women and Children from April 2015 to March 2016. The study included all singleton, full-term vaginal births. Multivariable logistic regression was used to estimate the odds of episiotomy by selected neonatal or maternal factors. Results Among 3,471 eligible singleton births, 2,770 mothers (79.8%) underwent an episiotomy. The episiotomy rate was significantly higher in first-time births (97.7%) compared to second or subsequent births (61.5%), p<0.001. Multivariable analyses showed that first-time births, higher birth weight, younger maternal age, a less physical active occupation, and a history of miscarriage were significantly associated with higher odds of episiotomy. For example, the odds of episiotomy in first-time births was 24.21 (95% CI: 17.13-34.22) times higher than in second or subsequent births, and the odds for mothers with a history of miscarriage was 1.34 (95%CI: 1.03-1.73) compared to those without. Stratified analysis showed that these associations persisted in multiparous women but were not observed in primiparous women. Conclusion This study highlights a very high episiotomy rate among primiparous women in Central Vietnam, one year after the implementation of restrictive episiotomy guidelines, despite of other maternal or neonatal factors associated with episiotomy in multiparous women. Comprehensive research and targeted interventions are needed to reduce episiotomy rates, particularly among first-time mothers in Vietnam.