Information et consentement sur l’épisiotomie : Comment améliorer les pratiques ?

Sante Publique. 2022;34(2):243-253.
[Article in French]

Abstract

Intro Context and subject of the study: While women are increasingly demanding to be actors of their birth and to participate in the choices concerning their care, a study showed in 2013 that the information they received concerning episiotomy had improved, but that consent was very rarely sought. The interest of our study was therefore to explore the practices of midwives a few years later, and to highlight the factors that may encourage or hinder them in the delivery room to inform women and obtain their consent.

Method: We conducted 12 semi-structured interviews with midwives working in the delivery room in several maternity hospitals in the Ile-de-France region. A manual content analysis was carried out independently by two researchers who then compared their results. A complementary analysis using NVivo software confirmed the validity of the manual analysis.

Results: Information on episiotomy and collection of consent in the delivery room were respectively limited by the anxiety-inducing nature of the information and its temporality (labour and delivery are not appropriate times for information according to the professionals), and by the fear of refusal. Information given beforehand during pregnancy and the drafting of a birth plan would facilitate the collection of consent in the delivery room.

Conclusion: A time dedicated to information and the distribution of an information leaflet on episiotomy to patients could help improve the practices of health professionals.

MeSH terms

  • Episiotomy*
  • Female
  • Humans
  • Informed Consent
  • Midwifery*
  • Parturition
  • Pregnancy
  • Prenatal Care