Episiotomy in Burkina Faso

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Global Health

Background:

• Episiotomy is a common obstetric procedure worldwide, but its necessity and impact on maternal morbidity are increasingly questioned.
• Limited data exists on episiotomy rates and practices in many African countries.
• Concerns are rising regarding the effectiveness of routine episiotomy in preventing severe perineal tears and neonatal asphyxia.

Purpose of the Study:

• To estimate the rates of episiotomy in Burkina Faso.
• To compare episiotomy rates based on the type of birth attendant (trained midwife vs. auxiliary midwife).
• To inform policy and practice regarding episiotomy in Burkina Faso.

Main Methods:

• Retrospective analysis of delivery data in Burkina Faso.
• Calculation of episiotomy rates among primigravidae based on attendant type.
• Comparison of perineal tear rates between groups.

Main Results:

• A high episiotomy rate of 46% was observed when trained midwives attended deliveries, indicating routine practice.
• A lower episiotomy rate of 26% was found for primigravidae delivered by auxiliary midwives, aligning with selective approaches.
• Similar rates of perineal tears were observed regardless of whether episiotomy was performed, suggesting limited benefit in tear prevention.

Conclusions:

• Routine episiotomy in Burkina Faso, particularly when attended by trained midwives, should be critically re-evaluated.
• Selective episiotomy practices, potentially facilitated by labor charts, may be a more appropriate approach.
• Evidence suggests that episiotomy does not necessarily prevent perineal tears and may contribute to maternal morbidity.