Evaluation of Evidence-based Episiotomy Practice by the Midwives

Omuga DB. "Evaluation of Evidence-based Episiotomy Practice by the Midwives." African Journal of Midwifery and Women's Health. 2010;4(2):80-86.


Research-based practice in nursing and midwifery is regarded as
, a means of ensuring that quality care is provided by integrating
individual clinical expertise with the best available clinical
evidence from systematic research. Previous studies indicate
that few midwives strive to achieve their role of safe motherhood
by helping women and their families through the pregnancy and
childbirth process using research-based practice. The study
documents the practice of episiotomy by midwives in an urban

This is a cross-sectlonal qualitative and quantitative descriptive
study. All midwives working in the labour ward at Pumwani
Maternity Hospital in June-July 2009 were eligible for the study.
A standard questionnaire was used to collect data regarding
soclo-demographlc characteristics, professional training and
evidence-based knowledge. Consenting and qualifying midwives
were eligible for study. In-depth interviews were conducted
among key informants over the same period. Data were analyzed
using Statistical Package for the Social Sciences (SPSS).
The most common types of episiotomy preferred by the midwives
was medio-Iateral and midline. Various factors were reported to
have influenced the midwives practices: very tight perineum,
breech presentation, premature labour, female genital mutilation,
instrumental delivery and status of the fetus. In-depth interviews
, demonstrated lack of specific guldellnes on specific procedures,
personal attitudes and inadequate administration support.
The study recommends an urgent need to put in place modalities
to ensure that guidelines are developed and used appropriately in order to standadize
provision of services.

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