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. 2025 Apr 30;25(1):522.
doi: 10.1186/s12884-025-07645-6.

Assessing the quality of life of postpartum mothers with episiotomy in the first six post-partum weeks: a descriptive cross-sectional study

Athuraliyage Diluni Umesha Dharmasiri  1 , Dewarahandhi Kavishka Madushan De Silva  2 , Ahangama Vidanagei Pramuditha Madhavi  3
Affiliations

Assessing the quality of life of postpartum mothers with episiotomy in the first six post-partum weeks: a descriptive cross-sectional study

Athuraliyage Diluni Umesha Dharmasiri et al. BMC Pregnancy Childbirth. .

Abstract

Background: An episiotomy is making a controlled incision to the perineal region to enlarge the vaginal opening to facilitate difficult childbirths. According to evidence-based guidelines from the World Health Organization (WHO), it is not recommended that this procedure be performed routinely due to its detrimental effects on mothers' postpartum quality of life (QOL). Therefore, this study aims to examine the QOL of postpartum mothers who experienced episiotomy during normal vaginal (NVD) delivery in a Tertiary care hospital in Sri Lanka.

Methods: A descriptive cross-sectional study was conducted with postpartum mothers (n = 131) who had experienced an episiotomy during NVD in a Tertiary care hospital, in Sri Lanka. Data were collected from November 2023 to January 2024, using the Maternal Postpartum QOL Instrument (MPQOL-1), a previously validated questionnaire comprising five sub-scales. Participants were voluntarily recruited from postpartum mothers attending postnatal clinics in the above setting. The collected data were analyzed by using SPSS software version 26.

Results: The study found that the majority of participants (71%) reported a high level of QOL related to episiotomy, while 28.2% had a moderate level. Factors such as parity, postpartum period, and number of episiotomies experienced significantly influenced QOL (p < 0.05). Women in the first postpartum week and those with fewer episiotomies reported higher QOL scores. Episiotomy complications are significantly associated with QOL, particularly regarding breastfeeding, newborn care, and bonding (p < 0.05).

Conclusions: Postpartum mothers generally report a high QOL following episiotomy, with parity, postpartum period, and the number of episiotomies influencing outcomes. Early postpartum women and those with fewer episiotomies experience better QOL. Episiotomy complications, however, negatively impact key aspects of maternal well-being, including breastfeeding, newborn care, and bonding, highlighting the importance of minimizing complications.

Keywords: Episiotomy; Postpartum mother; Quality of life.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The current study was ethically cleared by the Ethics Review Committee of Sabaragamuwa University of Sri Lanka under the ERC/H/7/2023/04 reference number. Written informed consent was obtained from each participant before data collection. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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