The current study assessed the QOL among postpartum mothers who experienced episiotomies, identifying key socio-demographic and obstetric factors influencing their QOL. The findings provide valuable insights into the postpartum recovery experience, specifically the impact of episiotomies on maternal well-being.
More than half of the participants were aged 25–34 years. This finding highlights that the majority of women in this population are likely to have experienced childbirth during their peak reproductive years [6]. A similar study also found that the mean age of the women who bore children was 28.65±5.60 years [24]. Complications related to episiotomies were relatively low, with only a small proportion experiencing lacerations and infections. These findings are important as they highlight that while episiotomies are common, the incidence of complications remains relatively low in the current context. However, the presence of complications such as lacerations or infections may significantly affect a woman’s quality of life during recovery and may need further investigation [25].
The overwhelming majority of participants reported a high quality of life, indicating that for most women, the recovery from episiotomy did not severely affect their overall well-being. Importantly, suggesting that overall postpartum recovery was favorable. This distribution is particularly notable when contrasted with existing literature, demonstrating that postpartum complications, including a complication of episiotomy, are likely to produce lower quality-of-life scores in a variety of different parameters.
However, the presence of complications notably alters this perception. Among those reporting complications, the overall quality of life takes a downturn, approximately 85% of participants reported no complications, while about 10% experienced complications from an episiotomy coupled with laceration stress on recovery. This supports the assertion that complications, such as infections, can exacerbate pain and emotional distress, leading to a negative influence on QOL [5, 23].
Considering the sub scales of QOL support from partners appear to play a crucial role. Participants reported a high median score in perceived partner support, reflecting the importance of emotional and social backing during recovery. This indicates that postpartum mothers in the current study expressed their pleasure in having supportive partners to share their physical and emotional feelings [26]. These findings highlight the crucial role of emotional and relational support from the partner in enhancing the psychological well-being of postpartum mothers, resulting in high QOL [26]. Supporting these findings, the findings of a cross-sectional survey conducted to assess the affective well-being of Chinese urban postpartum women found that positive affect had an association with spousal support [7]. Therefore, it is important to encourage partners’ involvement in the daily routine work of postpartum mothers and newborn care. The link of this support to QOL is also observed in the domain of intimacy, where partner comprehension dismantles fear of intimacy, previously shown to be influenced by episiotomy pain [27]. Further, Challenges in bonding with newborns and breastfeeding may be attributed to pain associated with episiotomies and the psychological implications of coping with these outcomes [28].
The results of this study also show significant associations between episiotomy related QOL and socio-demographic factors. The comparison between primiparous and multiparous women revealed a statistically significant difference in total QOL scores, with multiparous women reporting higher scores compared to primiparous women. This finding is consistent with existing literature indicating that multiparous women tend to have better QOL outcomes post-delivery due to greater experience and potentially better-coping mechanisms during and after childbirth [29]. Evidence suggests that women’s experiences and perceptions related to childbirth can improve with subsequent pregnancies, reducing anxiety and improving physical recovery times associated with deliveries and complications, including episiotomy [29,30,31].
Further, postpartum period also showed significant variation in QOL, precisely between the individuals in the first week postpartum and 2–3 weeks postpartum. This is in concurrence wit studies indicating the physiological and psychological transformation of mothers immediately following delivery [7]. Mental health, physical well-being concerns, and recovery are aspects that affect perceived QOL as levels of stress might be high in the postpartum period. Thus, the provision of care and support during this period in the early stage has been determined to enhance perceived QOL for postpartum women [7, 32].
Additionally, the significant differences in total QOL based on the number of episiotomies experienced also reveal noteworthy implications. This indicates a complex relationship where women undergoing multiple episiotomies may have varying perceptions of pain, recovery, and overall satisfaction with their birthing experiences [31, 32].
The current results shed light on several associations between subscales of QOL and the obstetric profiles of the participants. The impact of parity on the “Breastfeeding and newborn care” and “Managing activities of daily life” sub-scales are statistically significant. This suggests that first-time mothers may struggle significantly more with these aspects than those who have had more previous pregnancies, aligning with findings that indicate the complexity of maternal experiences, where first pregnancies often entail greater adaptation challenges [23, 33, 34].
The number of episiotomies experienced by the women also showed significant correlations with the scores on various MPQOL-I sub-scales. Specifically, women who had experienced one episiotomy reported a mean score of 9 (IQR 7) in breastfeeding and newborn care, while the median score for managing activities of daily life was 10 (IQR 4). These results suggest that even a single episiotomy can have lasting effects on maternal quality of life concerning both infant care and personal management [34, 35]. Conversely, this impact appears to intensify with increased numbers of episiotomies, as indicated by the diminishing scores in functional areas for higher episiotomy experiences, illustrating a direct correlation between obstetric interventions and postpartum adaptation [36, 37].
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