Magnitude of episiotomy practice and associated factors among Women who gave birth at Health Facilities in Asella Town: A Cross-Sectional Study, Oromia, Ethiopia, 2025

Abstract

Abstract Background: An episiotomy is an intended incision of the perineum to enlarge the vaginal opening for birth. Societies such as WHO, ACOG, and FIGO recommend restrictive episiotomy practice with WHO recommending a rate of less than 10%. Despite this recommendation, the finding of certain study shows the prevalence of practice is high in the country. This study will determine the magnitude of episiotomy practice and associated factors in health facilities in Asella town. Methods: Institution based cross-sectional study design was used. Data were collected using a semi-structured questionnaire administered by trained personnel using kobo toolbox then exported, cleaned and analyzed using Stata 14 statistical software. Descriptive statistics, frequency distribution tables, and graphs were used to present the data. Bivariate and multivariate logistic regression model was used to see relationships between dependent and independent variables. A p-value < 0.05 will indicate statistical significance. Results: Among 385 women who underwent vaginal delivery, the prevalence of episiotomy was 61.04%, with a significantly higher rate observed among primipara (83.06%) compared to multiparous women (41.09%). Multivariable logistic regression identified primiparity as the strongest predictor, with these women having 7.93 times higher odds of receiving an episiotomy (AOR = 7.93; 95% CI: 4.76–13.20) than multigravida women. Other independent predictors included a maternal BMI >25 kg/m² (AOR = 4.81; 95% CI: 2.11–10.97), high household income (>15,000 ETB) (AOR = 2.83; 95% CI: 1.34–5.96), and deliveries managed by medical interns (AOR = 2.71; 95% CI: 1.24–5.90). Conclusion: The prevalence of episiotomy in this study was 61.04%, which is higher than the recommended rate by WHO (10%). Multivariable analysis identified primi-parity, high maternal BMI, high household income, and the profession of the birth attendant as independent predictors of the procedure. The findings of the study indicate that episiotomy practice in the study area remains high and aligned with a routine approach than the evidence-based restrictive approach recommended by the WHO.