The Effect of Episiotomy Applied in Vaginal Delivery on Breastfeeding Self-Efficacy and Mother-Infant Attachment in the Postpartum Period

Abstract

Objective

The aim of this study was to examine the effect of episiotomy applied in vaginal delivery on breastfeeding self-efficacy and mother-infant attachment in the postpartum period.

Methods

This descriptive study includes 110 puerperal women who were registered in 3 family health centers in a district in Istanbul between July and December 2022 and had a vaginal delivery. Data was collected using a descriptive information form, maternal bonding scale and postpartum breastfeeding self-efficacy scale.

Results

The mean age of the participants was 30.04±5.13 years. 61.9% of the puerperal women were multiparous, the mean gestational age at delivery was 39±1.21 weeks, and 72.7% had an episiotomy at delivery. There was a statistically significant correlation between the number of deliveries, having problems during labor, and episiotomy application (p=0.005, p=0.044). There was no statistically significant difference between the maternal bonding scale scores and postpartumbreastfeeding self-efficacy scale scores of women who underwent episiotomy at delivery and women who did not.

Conclusion

Episiotomy alone had no effect on maternal bonding and postpartum breastfeeding self-efficacy, and episiotomy-induced pain was found to be an effective factor in the postpartum period.

Keywords

Bonding - Postpartum - Episiotomy - Self-efficacy - Breast feeding

Publication History

Received: 17 October 2024

Accepted: 23 January 2025

Article published online:
21 February 2025

• References

• 1 UNİCEF. Breastfeeding. 2002. Available from https://data.unicef.org/topic/nutrition/breastfeeding/ Accessed: 12/22/2002
• 2 Wiciński M, Sawicka E, Gębalski J. et al. Human milk oligosaccharides: health benefits, potential applications in infant formulas, and pharmacology. Nutrients 2020; 12: 266
• 3 Innis SM. Impact of maternal diet on human milk composition and neurological development of infants. Am J Clin Nutr 2014; 99: 734-741
• 4 UNICEF. Capture the Moment – Early initiation of breastfeeding: The best start for every newborn. 2018. Available from https://data.unicef.org/resources/capture-the moment/#:~:text=The%20World%20Health%20Organization%20(WHO,liquids%20are%20provided%2C%20including%20water
• 5 UNICEF. The state of the world’s children 2019. Available from https://www.unicef.org/reports/state-of-worlds-children-2019 Accessed: 7/24/2023
• 6 Turkey Demographic and Health Survey (TDHS). 2018. Available from http://www.sck.gov.tr/wp-content/uploads/2020/08/TNSA2018_ana_Rapor.pdf Accessed: 4/4/2023
• 7 Breastfeeding Challenges: ACOG Committee Opinion Summary, Number 820. Available from https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/02/breastfeeding-challenges Accessed: 7/24/2023
• 8 Gebrekidan K. Exclusive breastfeeding continuation and associated factors among employed women in North Ethiopia: A cross-sectional study. PloS One 2021; 16: e0252445
• 9 Cantürk D, Akgün Kostak M. First breastfeeding behaviours, breastfeeding self-efficacy levels and affecting factors of mothers who had vaginal delivery and cesarean operation. Mersin Univ Health Science Journal 2020; 13: 382-394
• 10 Aslan Y. Breastfeeding self-efficacy of mothers and its relationship with depression risk (Thesis). Konya, Türkiye: Selcuk University; 2016
• 11 Uçan S. The effect of breastfeeding education given to parents on breastfeeding process, cultural behaviours and parent-infant attachment (Thesis). Konya, Türkiye: Selcuk University; 2016
• 12 İnce T, Aktaş G, Aktepe N, Aydın A. Evaluation of the characteristics affecting mothers’ breastfeeding self-efficacy and breastfeeding success. Journal of Behçet Uz Children’s Hospital 2017; 7: 183-190
• 13 Gökçeoğlu E. Investigation of the relationship between mothers’ breastfeeding self-efficacy and milk adequacy perception (Thesis). Erzurum, Türkiye: Atatürk University; 2014
• 14 Erbaş N. Determination of health problems experienced by women in the postpartum period according to the type of birth: A sample from Sivas in 2012. J Contin Med Educ 2017; 26: 133-138
• 15 Kaviani MS, Azima S, Emamghoreishi M. et al. The effects of olive leaf extract ointment on pain intensity and early maternal complications in primiparous women. Int J Pharm Pharm Sci 2017; 9: 31-34
• 16 Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev 2017; 2017: CD000081
• 17 Kartal B, Kızılırmak A, Calpbinici P, Demir G. Retrospective analysis of episiotomy prevalence. J Turk German Gynecol Assn 2017; 18: 190-194
• 18 Kütük MS, Özgün MT, Uludağ S. et al. Abandonment of routine episiotomy practice: Erciyes University experience. Turk Klinik J Gynecol Obstet 2013; 23: 154-159
• 19 Shmueli A, Gabbay Benziv R, Hiersch L. et al. Episiotomy - risk factors and outcomes. J Matern Fetal Neonatal Med 2017; 30: 251-256
• 20 Kilci Ş, Bozkurt ÖD, Saruhan A. A violation of women’s rights: obstetric violence. J Arch Lit Rev 2020; 29: 122-128
• 21 National Institute for Health and Care Excellence (NICE). (2014). Clinical guideline 190: Intrapartum care for healthy women and babies 2014. Available from https://www.nice.org.uk/guidance/cg190#second-stage-of-lon Accessed: 4/4/2023
• 22 Esencan YT, Karabulut Ö, Yıldırım AD. et al. Mode of delivery, first breastfeeding time and skin-to-skin contact preferences of pregnant women receiving prenatal education. FNJN 2018; 26: 31-43. https://dergipark.org.tr/tr/pub/fnjn/issue/35751/387192
• 23 Çakır D, Alparslan Ö. Investigation of the effects of birth type variable on mother-infant interaction and mother’s perception of her baby. J Contemp Med 2018; 8: 139-147
• 24 Müller ME. A questionnaire to measure mother-to-infant attachment. J Nurs Meas 1994; 2: 129-141
• 25 Kavlak O, Şirin A. Adaptation of Maternal Attachment Scale to Turkish society. Int J Hum Sci 2009; 6: 188-202
• 26 Wheeler BJ, Dennis CL. Psychometric testing of the modified breastfeeding self-efficacy scale (short form) among mothers of ill or preterm infants. J Obstet Gynecol Neonatal Nurs 2013; 42: 70-80
• 27 Aluş TM, Çiler E, Semra E. et al. Reliability and validity study of Breastfeeding Self-Efficacy Scale (short form) designed for mothers with preterm newborns. Adnan Menderes University 1st International Health Sciences Congress, Aydın, Türkiye. 2017: 536
• 28 Agea-Cano I, Linares-Abad M, Ceballos-Fuentes AG, Calero-García MJ. Breastfeeding at 1, 3 and 6 months after birth according to the mode of birth: A correlation study. Int J Environ Res Public Health 2020; 17: 6828
• 29 Akın Ö, Erbil N. Mode of birth and breastfeeding: Systematic review. Ordu University Journal of Nursing Studies 2020; 3: 302-318
• 30 Dabiri F, Yabandeh AP, Shahi A. et al. The effect of mode of delivery on postpartum sexual functioning in primiparous women. Oman Med J 2014; 29: 276-279
• 31 Tatarlar A, Tokat MA. The effect of birth fear on lactation, infant sucking ability and first breastfeeding results. TAF Preventive Medicine Bulletin 2016; 15: 83-91
• 32 Abuhammad S, Johnson T. Breastfeeding and maternal attachment during infancy period among Jordanian mothers: A cross-sectional study. Ann Med Surg (Lond) 2021; 66: 102395
• 33 Amanak K, Demirkol İ, Ünay V. The effect of birth satisfaction on postpartum early postpartum breastfeeding self-efficacy. Turkish Journal of Science and Health. 2020 1. 50-57
• 34 Camarneiro AP, de Miranda Justo JM. Prenatal attachment and sociodemographic and clinical factors in Portuguese couples. J Reprod Infant Psychol 2017; 35: 212-222