The view of delivery by practitioners in routine episiotomy: a qualitative Study

(Received 21 Aug, 2008; Accepted 14 Jan, 2009)AbstractBackground and purpose: Many studies have determined desirable outcomes of elective episiotomy. However, the clinical practice is not based on results in many hospitals. For this reason, the present study assessed the view of practitioners regarding routine episiotomy.Materials and methods: This qualitative study was done by content analysis. A through semi-structured interview was done with obstetricians, midwives and midwifery trainers. After gathering information, common points of interviews were coded and stratified. Continuous comparison was done to obtain confidence of internal constancy in coding. For validity and reliability, three members of group coded the interviews independently, followed by defining the final theme. Themes were then returned to participants for confidence of their accuracy.Results: Twenty-four participants were assessed. Factors that influence the usage of routine episiotomy included 5 total concepts. Also, some partial concepts appeared as subcategory of total concepts. They were: 1. delivery agent (personal experience, skill, deficit of agents, fatigue and impatience, low knowledge, ability of communication with mother, and agent's role); 2. Mother (prevention and decline of injuries, anatomical differences, culture, not cooperating and, diseases); 3. Fetus (prevention and decline of trauma, conditions); 4. Legal problems (mother's complaints, remonstrance by seniors). 5. Method of management (non availibity of advanced technology, non usage of new methods for delivery, Mothers not being prepared).Conclusion: In a prolonged clinical practice, such as routine episiotomy, change is difficult. As studies recommend the limited use of episiotomy, intervention is necessary for changing practitioners' attitude and practice. Training of delivery agents, students and pregnant women are basic.