Review Shows No Benefit for Routine Episiotomy

[The Straight Story]

Review Shows No Benefit for Routine Episiotomy

Reuters Health

By Anthony J. Brown, MD

Wednesday, May 4, 2005

NEW YORK (Reuters Health) - Episiotomy, the incision used to widen the vaginal opening during delivery, should not be performed on a routine basis, according to a review of studies looking at this issue. Pregnant women treated with routine episiotomy do not fare better than other women plus they now have an incision that must heal.

Routine cutting of the vaginal opening was thought to make passage of the baby easier and prevent tears in the skin. Many believed this would promote better wound healing in the short term and reduce the risk of urinary or stool incontinence in the long term. However, the current findings provide no evidence to support any of these benefits.

The results reinforce the position held by the American College of Obstetricians and Gynecologists (ACOG) that routine episiotomy is unnecessary and may raise the risk of certain complications. This does not mean that episiotomy should never be performed, just not as a routine measure for all women undergoing vaginal delivery.

Despite the ACOG recommendation, it is estimated that up to 35 percent of vaginal deliveries involve routine episiotomy, lead author Dr. Katherine Hartmann, from the University of North Carolina at Chapel Hill, told Reuters Health. "I hope after our findings come out there will be a decline in use."

http://www.nlm.nih.gov/medlineplus/news/fullstory_24472.html

[Longhorn]

1. This is what my doctor told me 26 years ago!

I had four babies -- 9 lb. 13 oz, twins that weighed 8 lb. 7 oz and 7 lbs, and the last, 10 lb. 8 oz, and never had an episiotomy. My doctor said that a tear is easier to stitch than a cut because the edges line up better. He also said that a cut can sometimes lead to a more severe tear.

It's hard to believe that it is taking this long for this kind of "news" to get out!

[TNDemo]

2. I had two fourth degrees

one of which tore open all the way up. Blessedly had a C-section for the third (day at the beach compared to the others). I have wondered what another doctor could have done for that first one (had different doctors for each baby). They really should have all been sections (was on the table to have one with the second one when all hell broke loose and I aspirated and ended up in ICU and they managed to get him out the usual way) but they two vaginal ones had to have forceps. I wonder if I could have had less cutting or not.

[AlCzervik]

3. I was supposed to have one but it was too late

oh the burning but overall it was the least painful part of giving birth.