Knowledge,attitude and experience of episiotomy practice among obstetricians and midwives in Henan province

Objective After the introduction of restricted episiotomy and laceration suturing guideline, the episiotomy rate is still very high in Henan Province in 2019. The study is to explore the knowledge, attitude and practice towards the practice of episiotomy among clinicians in public hospitals. Methods With a self-administered survey questionnaire, the study was conducted among obstetricians and midwives in 90 public hospitals in Henan province, China. Results We enrolled 900(82. 21%) participants in this questionnaire. It was found that it is higher of participants' knowledge level on the complications and overuse. However, the episiotomy rate of nulliparouswas identified among participants with a significant difference at hospital level(P< 0. 01). The episiotomy rate in secondary hospitals was higher than the tertiary hospitals. The episiotomy rate also showed different with work experience(P< 0. 05). Less than half of clinicians(42. 11%) considered the current episiotomy rate(45%) was normal or too low.The most common reason for performing episiotomy by obstetricians(83. 94%) and midwives(79. 69%) was the reduction of 3 rd-4 th degree perineal tears. Both obstetricians(80. 29%) and midwives(82. 57 %) agreed that the most significant obstacle to reducing episiotomy rate was lack of training on reducing perineal tears. Conclusion This study confirmed that currentepisiotomy rate is much higher than the recommendation by WHO. It is urgent to fully implement related clinical policies and guidelines.