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A qualitative study exploring healthcare professionals' perceptions regarding selective versus routine episiotomy.
Uzma Akhtar1, Salma Rattani2, Rahila Mithani3
1Institute of Nursing Sciences, Sarhad University of Science & Information Technology, Peshawar, Pakistan.
Journal of Reproductive and Infant Psychology
|June 1, 2026
Summary
Healthcare providers prefer selective episiotomy but often perform routine episiotomies due to training gaps and institutional norms. Improving training and patient counseling is crucial for evidence-based practice.
Area of Science:
- Obstetrics and Gynecology
- Evidence-Based Medicine
- Healthcare Professional Education
Background:
- Episiotomy practices vary globally, with a shift towards selective approaches.
- Understanding healthcare providers' perspectives is key to optimizing clinical decision-making.
Purpose of the Study:
- To explore healthcare professionals' perceptions of selective versus routine episiotomy.
- To identify factors influencing episiotomy decision-making.
- To gather challenges and recommendations for implementing selective episiotomy.
Main Methods:
- Qualitative descriptive exploratory design.
- Purposive sampling of 15 obstetricians, nurses, and midwives.
- In-depth interviews analyzed thematically.
Main Results:
- Participants were unaware of international guidelines, relying on clinical judgment.
- Episiotomies were primarily performed to prevent severe perineal tears, with limited patient involvement.
- Routine episiotomy was common despite a preference for selective approaches, due to inadequate training and institutional norms.
Conclusions:
- A gap exists between preferred selective episiotomy and routine practice, influenced by institutional factors and training deficits.
- Enhanced training, updated guidelines, and improved patient counseling are essential for evidence-based episiotomy practices.
- Addressing these factors can lead to better clinical outcomes and patient care.
