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Patient attitude and acceptance towards episiotomy during pregnancy before and after information provision: a questionnaire

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Abstract

Introduction and hypothesis

Evidence regarding how women feel about episiotomies is not recorded in the literature. As the most common surgical procedure, there is a need to understand how women feel about episiotomy.

Methods

The primary outcome was to identify the percentage of women who would accept an episiotomy if required. A literature review was compiled to provide nulliparous women in their third trimester with evidence-based information about episiotomies and perineal tears. Questions eliciting demographics, pre-information level of anxiety and acceptance of episiotomy were asked. After reading the information sheets, anxiety and knowledge were assessed again. Changes in anxiety levels from pre- to post-information were investigated using paired samples t tests. Because anxiety was measured on a scale, we assessed potential departures from normality by using the Wilcoxon signed-rank test. Questions also assessed the value women placed on this form of education.

Results

There were 105 responses, with 88% accepting episiotomy, 2% declining and 10% seeking more information to decide. Eighty-one percent of women agreed that the information provided helped them to understand more about childbirth and 62% agreed that they felt more comfortable with the birthing process after reading the material. There was a reduction in anxiety levels regarding episiotomies after reading information (p = 0.002) and perineal tears (p = 0.02).

Conclusions

Most women will accept an episiotomy if required. Antenatal education about episiotomies is important to women and helps them feel more comfortable with the birthing process. Written information increases acceptance and reduces anxiety levels regarding episiotomies.

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Acknowledgements

Liz Ross provided extensive feedback and helped to edit the information package.

Imelda Manners provided midwifery feedback for developing the information package and logistical help for recruitment.

Author information

Authors and Affiliations

  1. The University of New South Wales, Sydney, Australia

    James W. Alexander, Emmanuel Karantanis, Robin M Turner & Kate Faasse

  2. St George Hospital, Kogarah, NSW, Australia

    James W. Alexander, Emmanuel Karantanis & Chelsea Watt

  3. Moorabbin Hospital, 823–865 Centre Road, Bentleigh East, NSW, 3165, Australia

    James W. Alexander

  4. University of Otago, Dunedin, New Zealand

    Robin M Turner

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  1. James W. Alexander
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  2. Emmanuel Karantanis
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  3. Robin M Turner
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  5. Chelsea Watt
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Correspondence to James W. Alexander.

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Conflicts of interest

The authors report no conflicts of interest.

Although no direct funding was received for the project, Dr. Faasse is supported by an Australian Research Council Discovery Early Career Research Fellowship (DE180100471).

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Alexander, J.W., Karantanis, E., Turner, R.M. et al. Patient attitude and acceptance towards episiotomy during pregnancy before and after information provision: a questionnaire. Int Urogynecol J 31, 521–528 (2020). https://doi.org/10.1007/s00192-019-04003-x

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  • DOI: https://doi.org/10.1007/s00192-019-04003-x

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