Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam
(1) Background: Routine episiotomy is not recommended by international guidelines; however, it occurs at a high rate in Vietnam. (2) Methods: A process to reduce unnecessary episiotomies was developed and implemented as part of the Centers of Excellence for Breastfeeding initiative, which aims to de...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/11/18/2520 |
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| author | Duong Hoang Vu Binh T. T. Ta Ina Landau Aasen Dai Q. T. Le Roger Mathisen Genevieve E. Becker Hang Thi Phan Cuong Minh Bui Trinh Thi Kieu Nguyen Suong Thi Thu Hoang Jennifer Cashin |
| author_facet | Duong Hoang Vu Binh T. T. Ta Ina Landau Aasen Dai Q. T. Le Roger Mathisen Genevieve E. Becker Hang Thi Phan Cuong Minh Bui Trinh Thi Kieu Nguyen Suong Thi Thu Hoang Jennifer Cashin |
| author_sort | Duong Hoang Vu |
| collection | DOAJ |
| description | (1) Background: Routine episiotomy is not recommended by international guidelines; however, it occurs at a high rate in Vietnam. (2) Methods: A process to reduce unnecessary episiotomies was developed and implemented as part of the Centers of Excellence for Breastfeeding initiative, which aims to deliver high-quality breastfeeding and early essential newborn care services within a supportive policy environment. The aim of this project report is to outline the steps undertaken to reduce episiotomies, the experience in pilot hospitals, and the process towards changing policy. (3) Results: During the 14 months following the change in episiotomy policy, pilot hospital records showed no infant death or injury. Monthly monitoring data from four pilot hospitals showed that the prevalence of episiotomy was substantially lower than the average in national hospitals in Vietnam. Facilitators to reducing the episiotomy rate include the incentive of Centers of Excellence for Breastfeeding designation and supportive hospital leadership. Challenges include the ambiguity of Vietnam’s national guideline on episiotomy and lack of routine monitoring on the episiotomy rate and indications. (4) Discussion: Our experience suggests that through training and routine monitoring hospitals can apply a policy of selective episiotomy and reduce the practice, particularly among multiparous women, and improve breastfeeding rates.(5) Conclusions: Sharing our experience of implementing this process and offering four areas for action will hopefully contribute to expanded use of mother-friendly, evidence-based care as policy and routine practice in Vietnam and similar settings. |
| first_indexed | 2024-03-10T22:42:20Z |
| format | Article |
| id | doaj.art-7311f555906e48748e9193873933d288 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-10T22:42:20Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-7311f555906e48748e9193873933d2882023-11-19T10:56:06ZengMDPI AGHealthcare2227-90322023-09-011118252010.3390/healthcare11182520Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in VietnamDuong Hoang Vu0Binh T. T. Ta1Ina Landau Aasen2Dai Q. T. Le3Roger Mathisen4Genevieve E. Becker5Hang Thi Phan6Cuong Minh Bui7Trinh Thi Kieu Nguyen8Suong Thi Thu Hoang9Jennifer Cashin10Alive & Thrive East Asia Pacific, FHI Solutions, Hanoi 11022, VietnamAlive & Thrive East Asia Pacific, FHI Solutions, Hanoi 11022, VietnamNorwegian Institute of Public Health (NIPH), N-0473 Oslo, NorwayAlive & Thrive East Asia Pacific, FHI Solutions, Hanoi 11022, VietnamAlive & Thrive East Asia Pacific, FHI Solutions, Hanoi 11022, VietnamBEST Services, H91 T22T Galway, IrelandHung Vuong Hospital, Ho Chi Minh City 72700, VietnamQuang Ninh Obstetrics and Pediatrics Hospital, Ha Long City 01100, VietnamQuang Nam Provincial General Hospital, Tam Ky 51100, VietnamPhu Vang District Hospital, Hue 49900, VietnamAlive & Thrive East Asia Pacific, FHI Solutions, Washington, DC 20037, USA(1) Background: Routine episiotomy is not recommended by international guidelines; however, it occurs at a high rate in Vietnam. (2) Methods: A process to reduce unnecessary episiotomies was developed and implemented as part of the Centers of Excellence for Breastfeeding initiative, which aims to deliver high-quality breastfeeding and early essential newborn care services within a supportive policy environment. The aim of this project report is to outline the steps undertaken to reduce episiotomies, the experience in pilot hospitals, and the process towards changing policy. (3) Results: During the 14 months following the change in episiotomy policy, pilot hospital records showed no infant death or injury. Monthly monitoring data from four pilot hospitals showed that the prevalence of episiotomy was substantially lower than the average in national hospitals in Vietnam. Facilitators to reducing the episiotomy rate include the incentive of Centers of Excellence for Breastfeeding designation and supportive hospital leadership. Challenges include the ambiguity of Vietnam’s national guideline on episiotomy and lack of routine monitoring on the episiotomy rate and indications. (4) Discussion: Our experience suggests that through training and routine monitoring hospitals can apply a policy of selective episiotomy and reduce the practice, particularly among multiparous women, and improve breastfeeding rates.(5) Conclusions: Sharing our experience of implementing this process and offering four areas for action will hopefully contribute to expanded use of mother-friendly, evidence-based care as policy and routine practice in Vietnam and similar settings.https://www.mdpi.com/2227-9032/11/18/2520episiotomyvaginal childbirthearly essential newborn careguidelinequality of carebreastfeeding |
| spellingShingle | Duong Hoang Vu Binh T. T. Ta Ina Landau Aasen Dai Q. T. Le Roger Mathisen Genevieve E. Becker Hang Thi Phan Cuong Minh Bui Trinh Thi Kieu Nguyen Suong Thi Thu Hoang Jennifer Cashin Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam Healthcare episiotomy vaginal childbirth early essential newborn care guideline quality of care breastfeeding |
| title | Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam |
| title_full | Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam |
| title_fullStr | Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam |
| title_full_unstemmed | Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam |
| title_short | Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam |
| title_sort | promoting respectful maternity care by reducing unnecessary episiotomies experiences from centers of excellence for breastfeeding in vietnam |
| topic | episiotomy vaginal childbirth early essential newborn care guideline quality of care breastfeeding |
| url | https://www.mdpi.com/2227-9032/11/18/2520 |
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