Risk factors associated with severe perineal tear at Public Hospitals in Bahir Dar town, Northwest Ethiopia

Background: Birth-related perineal trauma is a public health issue that can lead to significant maternal morbidity in low-income countries like Ethiopia. Research on the proportion and underlying factors of birth-related severe perineal tears is rare, both in the study area and throughout Ethiopia. As a result, this study was intended to determine the proportion of birth-related severe perineal tears and associated factors at hospitals in Bahir Dar town, Ethiopia. Methods: A cross-sectional study was undertaken at government hospitals in Bahir Dar, Ethiopia. Five hundred fifteen study subjects were selected using a systematic sampling technique. The data was collected through chart reviews and interviews. Data was entered and analyzed using SPSS Version 23. A binary logistic regression was employed to identify factors, and an adjusted odds ratio and a 95% CI were used to estimate the strength of relationships. Statistical significance was declared at p-value < 0.05. Result: The prevalence of severe perineal tears was 7.4%. Previous history of a perineal tear (AOR = 3.06, 95% CI = 1.24-7.59), being nullipara (AOR = 4.03, 95% CI = 1.42-11.44), occipito-posterior position (AOR = 5.49, 95% CI = 2.27-13.28), duration of second stage of labor > 2 h (AOR = 5.42, 95% CI = 2.26-12.99), birth attendant's work experience <1 year (AOR = 5.98, 95% CI = 2.16-16.57) were found to be associated with birth-related severe perineal tear. Conclusion: The proportion of birth-related severe perineal tears was high at governmental hospitals in Bahir Dar town. Previous history of perineal tear, work experience of birth attendants, duration of the second stage of labor, being nullipara, and occipito-posterior position were the major determinants of severe perineal tear. This study suggests that strategies and regulations should be developed to shorten the second stage of labor.