Factors related to episiotomy practice: an evidence-based medicine systematic review

Episiotomy practice is influenced by many factors studied in the scientific literature. Evidence-based medicine has isolated many factors that are linked to episiotomy practice, thus creating a need to group all these factors to create a relevant and useful database for scientific research. Based on the PRISMA methodology, the authors conducted a systematic literature review with the aim of covering this very need. Using 12 French and English combinations of relevant keywords, 15 databases containing publications published between 2008 and 2018 were evaluated. A total of 63 articles were identified, grouped and categorised into four main themes in the results section: (1) Individual and clinical factors related to the mother, (2) individual and clinical factors related to the child, (3) technical factors, and (4) organisation of health care and professional factors (institutional, organisational, personal and professional factors). These factors are then presented in terms of their impact on the practice of episiotomy. Then the future implications of this study on scientific research and clinical practice are discussed.