Background: Episiotomy rates remain high in some regions, despite questions about its benefits. This study investigates the prevalence of episiotomy in a rural Ethiopian hospital (2019) and explores links between episiotomy use, labor complications (vacuum deliveries), and newbornhealth (low Apgar scores).

Methods: A cross-sectional study reviewed 300 vaginal deliveries at Batu General Hospital from January-March 2019. We analyzed data on maternal age, mode of delivery, neonate sex, first-minute Apgar score, and episiotomy use.

Results: Episiotomy was performed in 26% (78/300) of deliveries. Mothers who delivered with vacuum assistance were 15.17 times more likely to experience episiotomy compared to those with spontaneous vaginal delivery. Deliveries with low Apgar scores had 6.11 times higher odds of episiotomy compared to normal Apgar scores.

Conclusion: This study highlights a high episiotomy rate in this setting.Labor complications, particularly those requiring instrumental deliveriesand resulting in low Apgar scores, are significantly associated withepisiotomy use. Further investigation is needed to determine if reducingunnecessary episiotomy is feasible while ensuring safe deliveries formothers and newborns in this context.