Women’s Involvement in Decision Making: Episiotomy Procedure

Abstract

Abstract:Background: Involving patient in decision making for their care can enhance satisfaction and promote health outcomes in particular in the nursing fields. As The World Health Organization Principles of Perinatal Care has recommended that care should involve women in decision making. This principle strongly endorses for improving effective perinatal care. Decision making regard to treatment options is a concept that has increased widespread appeals to healthcare providers and users in recent year. Evidently, patient involvement in decision making has not always been implemented in clinical practice in particular during intrapartum period. Objective: The aim of this study was to investigate the involvement of women in decision making on episiotomy procedure during labor. Methods: A descriptive quantitative approach was conducted using selfadministered survey questionnaires in two government hospitals, Bangkok, Thailand. Participating hospitals were identified by convenience and remained anonymous. The Participant, eligible women included those who have reached 37 to 42 weeks of gestation, experienced vaginal birth, have a live baby, and admitted in the postpartum units. An appropriate sample size was assigned based on a 95 percent confidence level. A sample size was drawn from two hospitals based on a binomial probability distribution. There were 400 postpartum women participated in this study. Anonymous patient's data were analyzed using frequencies and percentages. Results: The results revealed that 80% of all women experienced episiotomy. The finding demonstrated that decision making on having this procedure made by health care providers and relatives 73.8%, 3.2%, respectively. 23% of them had a chance to make a decision on having episiotomy. There were 23.8% of women received information about risks and benefits of episiotomy procedure and 76.2% did not get information. Conclusion: The findings of this study demonstrated that women have less opportunity to make a decision on having episiotomy during labor and received less information about this procedure. Therefore, health care providers should be clearly discussed about risks and benefits of episiotomy before performing the procedure. The factors influencing patient involvement in decision making should be investigated to promote good experiences of women during delivery and increase satisfaction toward their care.

Attitude and knowledge of Latvian women towards episiotomy

“…The decision of performing the procedure was made mostly by their health care provider, a similar situation is also observed in other studies. 17 Episiotomy being one of the most frequent surgical interventions, still is overlooked and does not fulfil the steps and measures as any other surgical manipulation. 18 As seen in our study, women should be informed about the procedure, its risks and possible outcomes, and have the option to make an informed decision.…”

Women acceptance of episiotomy procedure before and after receiving educational materials: Pretest posttest study

“…Alexander et al reported that antenatal education about episiotomy helped comfort women about the process of giving birth and increased the level of acceptance of the procedure when indicated [1] . Patients’ understanding and involvement in decision-making have proven to raise satisfactory levels and quality of care [13] . It is now the role of physicians to weigh the risks and benefits of episiotomy and individualize each experience of birth.…”

“…Patients’ involvement in the process of decision-making had proven to raise satisfactory levels and quality of care [13] . Edwin et al had advocated to adopt a patient-oriented approach to improve patients understanding [14] .…”

Perspectives of skilled birth attendants and pregnant women regarding episiotomy: a quantitative approach

“…Since the beginning of the twenty first century, the practice of routine episiotomy by midwives and obstetricians have remained under public scrutiny 14 . The alignment of the clinicians reasons for episiotomy with maternal preference for episiotomy have generated discourse among researchers and clinicians globally 15 . Consequently, a study of this nature which is aimed at examining the perspectives of skilled birth attendants and pregnant women regarding episiotomy in health facilities within Africa is justified.…”