Beyond the Birth: Study shows How Episiotomy Shapes Maternal Postpartum Experience?

Recent study evaluates the quality of life (QOL) among postpartum mothers who underwent episiotomy during vaginal delivery, addressing the implications of this procedure against the World Health Organization's (WHO) guidelines which discourage its routine use. Conducted in a tertiary care hospital in Sri Lanka, the research involved 131 postpartum mothers within the first six weeks following childbirth.

Impact of Episiotomy

An episiotomy, typically performed to facilitate difficult deliveries, may lead to physical and psychological adverse effects. The WHO recommends limiting episiotomy rates due to these negative consequences. Despite the evidence, episiotomy prevalence remains high in Sri Lanka, with 97% of postpartum women undergoing the procedure without anesthesia, resulting in potential complications and impacting QOL significantly.

Data Collection and Findings

Data were collected through self-administered questionnaires that included socio-demographic information and an assessment of QOL using the validated Maternal Postpartum Quality of Life (MPQOL-1) instrument. The study revealed a median QOL score of 65 among participants, with 71% reporting high and 28% moderate QOL. Factors associated with improved QOL included parity, mode of delivery, and the postpartum period. Notably, multiparous women exhibited higher QOL scores than primiparous counterparts. The timing of responses also influenced QOL, with the highest scores noted in the first week postpartum.

Complications and QOL

The analysis highlighted that postpartum mothers experiencing complications from episiotomy reported lower QOL, particularly in areas concerning bonding with the newborn and breastfeeding. Interestingly, the number of episiotomies correlated inversely with QOL, indicating that repeated procedures negatively affect various life areas, including managing daily activities and overall maternal well-being.

Role of Partner Support

Results indicated that perceived partner support significantly contributed to better QOL outcomes, underscoring the essential role of emotional and social backing during recovery. Despite the reported high scores, the study noted that those with episiotomy complications experienced considerable pain and emotional distress that reduced their QOL. This research emphasizes critical implications for obstetric care, particularly in Sri Lanka, where adherence to guidelines could enhance postpartum recovery experiences. The findings advocate for improved postnatal care to manage complications, thereby positively affecting mothers' quality of life. Future studies should factor in diverse regions and longer postpartum periods to comprehensively address these challenges.

Key Points

- The study assesses the quality of life (QOL) of postpartum mothers who underwent episiotomy, contrasting findings with WHO guidelines that discourage routine use due to associated adverse effects.

- Conducted in a tertiary care facility in Sri Lanka, the research involved 131 postpartum mothers within six weeks post-delivery, revealing an alarming rate of 97% undergoing episiotomy without anesthesia, which may exacerbate complications and negatively impact QOL.

- Self-administered questionnaires collected socio-demographic data and assessed QOL using the Maternal Postpartum Quality of Life (MPQOL-1) instrument, yielding a median QOL score of 65, with 71% of participants rated as having high quality of life, while 28% reported moderate QOL.

- Key factors influencing QOL included parity, mode of delivery, and timing of responses, with multiparous women showing higher QOL scores compared to primiparous women, and the highest QOL scores observed during the first week postpartum.

- Complications stemming from episiotomy directly correlated with lower QOL scores, specifically affecting maternal bonding and breastfeeding, while the frequency of episiotomies had an inverse relationship with QOL across multiple life domains.

- Perceived partner support played a significant role in enhancing QOL outcomes, yet mothers with complications reported substantial pain and emotional distress that negatively impacted their overall quality of life, calling for improved adherence to obstetric care guidelines and postnatal management practices in Sri Lanka.

Reference –

Athuraliyage Diluni Umesha Dharmasiri et al. (2025). Assessing The Quality Of Life Of Postpartum Mothers With Episiotomy In The First Six Post-Partum Weeks: A Descriptive Cross-Sectional Study. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07645-6.