Articles producció científica> Medicina i Cirurgia

Health care workers' perceptions of episiotomy in the era of respectful maternity care: a qualitative study of an obstetric training program in Mexico

  • Identification data

    Identifier: imarina:9261665
    Authors:
    Garcia-Cerde, RodrigoTorres-Pereda, PilarOlvera-Garcia, MariselaHulme, Jennifer
    Abstract:
    Background Episiotomy in Mexico is highly prevalent and often routine - performed in up to 95% of births to primiparous women. The WHO suggests that episiotomy be used in selective cases, with an expected prevalence of 15%. Training programs to date have been unsuccessful in changing this practice. This research aims to understand how and why this practice persists despite shifts in knowledge and attitudes facilitated by the implementation of an obstetric training program. Methods This is a descriptive and interpretative qualitative study. We conducted 53 pre and post-intervention (PRONTO (c) Program) semi-structured interviews with general physician, gynecologists and nurses (N = 32, 56% women). Thematic analysis was carried out using Atlas-ti (c) software to iteratively organize codes. Through interpretive triangulation, the team found theoretical saturation and explanatory depth on key analytical categories. Results Themes fell into five major themes surrounding their perceptions of episiotomy: as a preventive measure, as a procedure that resolves problems in the moment, as a practice that gives the clinician control, as a risky practice, and the role of social norms in practicing it. Results show contradictory discourses among professionals. Despite the growing support for the selective use of episiotomy, it remains positively perceived as an effective prophylaxis for the complications of childbirth while maintaining control in the hands of health care providers. Conclusions Perceptions of episiotomy shed light on how and why routine episiotomy persists, and provides insight into the multi-faceted approaches that will be required to affect this harmful obstetrical practice.
  • Others:

    Author, as appears in the article.: Garcia-Cerde, Rodrigo; Torres-Pereda, Pilar; Olvera-Garcia, Marisela; Hulme, Jennifer;
    Department: Medicina i Cirurgia
    URV's Author/s: Torres Pereda, Maria Del Pilar
    Keywords: Teaching hospitals Routine episiotomy Restrictive episiotomy Respectful maternity care Qualitative research Practice guidelines Neonatal emergencies Mixed-methods Management Lacerations Episiotomy Beliefs Association
    Abstract: Background Episiotomy in Mexico is highly prevalent and often routine - performed in up to 95% of births to primiparous women. The WHO suggests that episiotomy be used in selective cases, with an expected prevalence of 15%. Training programs to date have been unsuccessful in changing this practice. This research aims to understand how and why this practice persists despite shifts in knowledge and attitudes facilitated by the implementation of an obstetric training program. Methods This is a descriptive and interpretative qualitative study. We conducted 53 pre and post-intervention (PRONTO (c) Program) semi-structured interviews with general physician, gynecologists and nurses (N = 32, 56% women). Thematic analysis was carried out using Atlas-ti (c) software to iteratively organize codes. Through interpretive triangulation, the team found theoretical saturation and explanatory depth on key analytical categories. Results Themes fell into five major themes surrounding their perceptions of episiotomy: as a preventive measure, as a procedure that resolves problems in the moment, as a practice that gives the clinician control, as a risky practice, and the role of social norms in practicing it. Results show contradictory discourses among professionals. Despite the growing support for the selective use of episiotomy, it remains positively perceived as an effective prophylaxis for the complications of childbirth while maintaining control in the hands of health care providers. Conclusions Perceptions of episiotomy shed light on how and why routine episiotomy persists, and provides insight into the multi-faceted approaches that will be required to affect this harmful obstetrical practice.
    Thematic Areas: Surgery Serviço social Saúde coletiva Odontología Obstetrics and gynecology Obstetrics & gynecology Nutrição Medicina iii Medicina ii Medicina i Materiais Matemática / probabilidade e estatística Interdisciplinar Ensino Enfermagem Educação física Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Biotecnología Administração pública e de empresas, ciências contábeis e turismo
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: mariadelpilar.torres@estudiants.urv.cat
    Author identifier: 0000-0003-1869-2044
    Record's date: 2024-07-27
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://link.springer.com/article/10.1186/s12884-021-04022-x
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Bmc Pregnancy And Childbirth. 21 (1):
    APA: Garcia-Cerde, Rodrigo; Torres-Pereda, Pilar; Olvera-Garcia, Marisela; Hulme, Jennifer; (2021). Health care workers' perceptions of episiotomy in the era of respectful maternity care: a qualitative study of an obstetric training program in Mexico. Bmc Pregnancy And Childbirth, 21(1), -. DOI: 10.1186/s12884-021-04022-x
    Article's DOI: 10.1186/s12884-021-04022-x
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2021
    Publication Type: Journal Publications
  • Keywords:

    Obstetrics & Gynecology,Obstetrics and Gynecology,Surgery
    Teaching hospitals
    Routine episiotomy
    Restrictive episiotomy
    Respectful maternity care
    Qualitative research
    Practice guidelines
    Neonatal emergencies
    Mixed-methods
    Management
    Lacerations
    Episiotomy
    Beliefs
    Association
    Surgery
    Serviço social
    Saúde coletiva
    Odontología
    Obstetrics and gynecology
    Obstetrics & gynecology
    Nutrição
    Medicina iii
    Medicina ii
    Medicina i
    Materiais
    Matemática / probabilidade e estatística
    Interdisciplinar
    Ensino
    Enfermagem
    Educação física
    Ciências biológicas iii
    Ciências biológicas ii
    Ciências biológicas i
    Biotecnología
    Administração pública e de empresas, ciências contábeis e turismo
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