Attitude of maternity staff regarding episiotomies in an African rural hospital with high HIV prevalence: a descriptive qualitative study.

In a typical sub-Saharan African rural hospital, maternity staff seems to avoid episiotomies. The aim of this research is to develop a deeper understanding in the attitude of maternity staff regarding episiotomies. We used a descriptive qualitative approach: interviews, written questionnaires, and a group discussion. All methods showed strong reservations toward episiotomies among staff members. Most staff members have been trained to be very restrictive concerning episiotomies to prevent the transmission of human immunodeficiency virus (HIV). As a result of training and hence changing attitudes, the use of episiotomies is limited in all patients; even when strong indications are present and sometimes regardless of HIV status. This might increase the number of neonatal deaths.