title: Determinants of episiotomy in rural Zimbabwe.
abstract: BACKGROUND
  To assess the influence of parity, mode of birth, place of birth, a history of birth by only cesarean section and birthweight on episiotomy rates.
  
  
  METHODS
  Retrospective study of 3589 women giving birth vaginally from October 1997 to October 1998 in the Gutu district in Zimbabwe, to obtain the rate of episiotomy and its determinants.
  
  
  RESULTS
  The overall episiotomy rate was 27%; 54% in nulliparous and 6% in multiparous women. Perineal tears varied between 5 and 11% in the different places of birth.
  
  
  CONCLUSIONS
  An episiotomy rate of 54% in nulliparous women is higher than necessary. Medical and midwifery training should be adapted to facilitate a more restrictive use of episiotomy.
authors.affiliation: Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Janneke E
authors.initials: JE
authors.lastname: van den Bergh
authors.forename: Marieke
authors.initials: M
authors.lastname: Sueters
authors.forename: Marc
authors.initials: M
authors.lastname: Segaar
authors.forename: Jos
authors.initials: J
authors.lastname: van Roosmalen
mesh_terms: D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004841:Episiotomy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008499:Medical Records; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D012423:Rural Health; D019564:Unnecessary Procedures / Q000706:statistics & numerical data; D015030:Zimbabwe / Q000453:epidemiology