Impact of intrapartum midwifery-led care on routine episiotomy rates in a public health care setting in South India

In Indian health care settings Midwifery-led care is in its infancy. In public maternity settings, practice of prophylactic episiotomy is implemented for all primigravidae and for those with diagnosis of meconium-stained liquor or LGA baby. From December 2020 to January 2021, 55 mothers were supported during birth by the midwifery mentors and trainees of the Telangana State Nurse Practitioner in Midwifery [NPM] program.  The group we studied had 24(44%) primigravidae, 52(95%) with term gestation and 3(5%) with MSL. Perineal protective measures like intrapartum mobilization, warm perineal compresses during active second stage, birth positions of choice along with perineal support and helping mothers breathe out their baby slowly were used. Results revealed only 3(5%) mothers needed an episiotomy, 22(40%) had intact perineum post-birth . None had extensive tears. Twenty one (38%) babies had birth weight of 3kgs and greater while 53(96%) enjoyed the first golden hour with skin-to-skin contact.