The effect of problem solving training to midwife on the frequency of selective episiotomy in nulliparous women

Mina Ghalenovi,1,* Zahra abedian,2

1. master of midwifery, faculty member of sabzevar university of medical sciences, hran
2. Master of Midwifery, Faculty member of Mashhad University of Medical Sciences, Iran



The need for episiotomy is a decision made finally by midwives. problem-solving ability to overcome unforeseen situations helps and makes no other person needs. these skills increase the use of effective coping strategies. this study aimed to determine the effect of problem solving training to midwives on selective episiotomy in nulliparous women.


This randomized clinical trial was conducted on60midwives in maternity hospitals of mashhad in 2015.the subjects were selected by simple random then were divided into two groups based on random numbers table. the samples were asked to complete the demographic, occupational and bar-on problem solving questionnaire at the beginning and end of the study. in intervention group, midwives were asked to attend two 4-hours training sessions. they delivered2babies before the intervention (singleton, cephalic, term and without anomaly)and2after that. in the control group4deliveries were done. elective or non-elective episiotomy indications were determined by researcher according to the check list. data were analyzed by using spss16software and chi-square test, mann-whitney, wilcoxon. confidence level was considered0.95.


Mean scores for problem solving midwives were23.2±2.2and23.1±2.0before and after intervention, respectively no significant difference was observed(p=0.320).there was no significant difference between before and after intervention in the control group(p=0.537).33.3%and41.7%of episiotomies were performed selectively before and after the intervention, respectively.there was no significantly difference between the two groups at the beginning(p=0.847)and end of the study(p=0.582)in terms of the frequency of selective episiotomy.


. in this study,short-term and temporary problem solving training workshops was not successful in improving the skills and increase the decision of more selective episiotomy by midwives


Problem solving, midwife, nulliparous, selective episiotomy