Perineal Management and Episiotomy Practice in Chile

Episiotomy is a common intervention used during the second stage of delivery. Current use of this procedure is restricted to certain births due to several complications. Almost all births in Chile are delivered by a gynecologist or a midwife in the public or private health system where episiotomy is performed. The objective of this study is to identify strengths and weakness in aspects of perineal management and episiotomy practice among obstetric health care providers with the purpose of promoting practice assessment and updating skills and competencies. Design: Questionnaire-based-cross-sectional study. Method: Anonymous questionnaire applied to gynecologists and midwives of public and private hospitals, between October and December 2019 using the Instrument designed by Cornet et al. addressing questions such as affiliation, number of births/year, knowledge of anatomy, knowledge of episiotomy, knowledge of perineal tear, competence in perineal repair, and presence of expert in perineal trauma at their unit. Results: 189 surveys responded, 51% from midwives and 37.6% from doctors. 71% of total were trained at their medical or midwifery schools and 69% during postgraduate internships. Episiotomy practice criteria: 19% always in primigravida patients and 14,3% always in premature deliveries. Majority of professionals, 79.4% with less than 100 deliveries a year had incorrect answers about depth or sphincter tear prevention technique. Conclusions: The majority of professionals indicated insufficient training capacities in relation to episiotomy techniques. Undergraduate programs should strength training on this intervention, national guidelines must include routine episiotomy performance in order to unify criteria