The practice of episiotomy in a university teaching hospital in Nigeria: How satisfactory?

Background : Episiotomy is essentially a surgical procedure but it is often relegated to the least experienced member of the obstetric team with possible untoward consequences to the mother. Aim : This study set out to appraise how episiotomy was practiced in the University of Calabar Teaching Hospital during the period of the study. Materials and Methods : It was a cross sectional exploratory study which assessed episiotomy and episiorrhaphy procedures among parturients in the centre. Results : Thirty two percent of the 275 parturients studied did not know what episiotomy means. The majority (61.5%) of the parturients were not counseled on the need for episiotomy before the procedure was performed on them. The mean delivery-repair interval for episiotomy among parturients in the study population was 17.9 + 5.66 minutes. Most (75.6%) of the episiotomies were performed by midwives. A significant proportion (45.8%) of the parturients had episiotomy performed on them without prior administration of local anaesthesia. The majority (52.7%) of the episiotomies were repaired by house officers. Common complications among women in the study population were perineal discomfort, perineal pain and difficulty in breastfeeding. Conclusion : The practice of episiotomy in the studied University Teaching Hospital during the period of the study did not meet all necessary requirements of a surgical procedure. Senior members of the obstetric team should supervise the practice in order to ensure the maintenance of standard. Keywords : Episiotomy, episiorrhaphy, surgical procedure, practice, counseling