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Original research
Women’s experience of episiotomy: a qualitative study from China
  1. Siyuan He1,2,
  2. Hong Jiang1,2,3,
  3. Xu Qian1,2,3,
  4. Paul Garner4
  1. 1School of Public Health, Fudan University, Shanghai, China
  2. 2Global Health Institute, Fudan University, Shanghai, China
  3. 3National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
  4. 4Centre for Evidence Synthesis in Global Health, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
  1. Correspondence to Professor Xu Qian; xqian{at}


Objective To describe women’s experience of episiotomy in urban China.

Design This is a semistructured, indepth interview with women after episiotomy. We analysed transcriptions using thematic analysis in Chinese. Emerging themes were debated in English to finalise interpretation.

Setting Two community health centres and four hospitals in Shanghai, China.

Participants Purposive sampling of 30 postpartum women who had experienced episiotomy; 25 were primiparous and 4 had deliveries by forceps. We interviewed health providers to complement the data.

Results We identified four main themes: (1) women’s views of the procedure vary considerably; (2) pain interferes with daily life for weeks; (3) long-term anxiety is a consequence for some, described as a ‘psychological shadow’; and (4) societal norms assume women will not complain.

Conclusion Women receive little information in advance about episiotomy, yet the procedure has a wide range of physical and psychological consequences. This includes long-term anxiety about the damage done to them as women.

  • episiotomy
  • perineal trauma
  • women’s experience

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  • SH and HJ are joint first authors.

  • SH and HJ contributed equally.

  • Contributors SH, HJ and XQ designed the study and analysed data. SH and HJ drafted the paper, and XQ revised it. PG helped with analysis, commented on interpretation and helped write the manuscript. SH and HJ contributed equally to this study and should be regarded as co-first authors. All authors have verified and approved the final version of the abstract for publication.

  • Funding This work received support from the Effective Health Care Research Consortium, funded by UK aid from the UK government for the benefit of developing countries (grant: 5242).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

  • Ethics approval The research obtained approval from the Institutional Review Board of the School of Public Health, Fudan University (ID: 2017-12-0648).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.