Determinants of episiotomy in rural Zimbabwe

Background. To assess the influence of parity, mode of birth, place of birth, a history of birth by only cesarean section and birthweight on episiotomy rates. Methods. Retrospective study of 3589 women giving birth vaginally from October 1997 to October 1998 in the Gutu district in Zimbabwe, to obtain the rate of episiotomy and its determinants. Results. The overall episiotomy rate was 27%; 54% in nulliparous and 6% in multiparous women. Perineal tears varied between 5 and 11% in the different places of birth. Discussion. An episiotomy rate of 54% in nulliparous women is higher than necessary. Medical and midwifery training should be adapted to facilitate a more restrictive use of episiotomy.