Anatomical Competence in Episiotomy Repair Among Midwives in Kaduna State: Assessment and Training Needs

Episiotomy repair is a fundamental obstetric skill requiring precise anatomical knowledge of perineal layers, including the skin, subcutaneous fat, bulbocavernosus muscle, perineal membrane, and vaginal epithelium. Incorrect identification and repair of these layers leads to complications such as dehiscence, haematoma, rectovaginal fistula, and chronic perineal pain. Midwives in Nigeria perform a substantial proportion of all episiotomies and their repairs, yet the adequacy of their anatomical training for this procedure has not been systematically evaluated. This study aims to assess the anatomical competence of midwives performing episiotomy repair in government-owned maternity hospitals across Kaduna State, North West Nigeria. A structured anatomical knowledge questionnaire and a skills assessment using a silicone perineal repair model will be administered to 120 midwives recruited from five government hospitals. Competence gaps will be identified and analysed by qualification level and years in obstetric practice. The study anticipates producing a training needs profile and a competency-based anatomical refresher module for midwives in Kaduna State, contributing to improved obstetric care quality.

Keywords: episiotomy repair, perineal anatomy, midwifery competence, Kaduna State, obstetric training